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Individual

HARRISON M FRIEND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1111 CRATER LAKE AVE, MEDFORD, OR 97504
(541) 732-5000
Mailing address
1125 NE ORENCO STATION PKWY APT F107, HILLSBORO, OR 97124-4443
(541) 941-0800

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA190211
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA190211
OREGON MEDICAL BOARD PHYSICIAN ASSISTANT LICENSE
OR
Enumeration date
05/09/2018
Last updated
10/08/2021
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