Individual
VINCENT HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213
(503) 000-0000
(503) 000-0000
Mailing address
PO BOX 1334, PORTLAND, OR 97207-1334
(313) 347-3290
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301082279
MI
208600000X
Surgery Physician
Primary
MD29110
OR
Other
Enumeration date
06/05/2007
Last updated
06/04/2014
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