Individual
DR. CHARLES WAY HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1210 SE OAK ST, PORTLAND, OR 97214-1427
(503) 975-0014
(503) 283-7085
Mailing address
PO BOX 17658, PORTLAND, OR 97217-0658
(503) 975-0014
(503) 283-7085
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1148
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500612148
—
OR
Enumeration date
11/15/2005
Last updated
07/23/2015
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