Individual
MARJORIE NICOLE HARVILL-BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
940 ROYAL AVE, SUITE 350, MEDFORD, OR 97504-6193
(541) 732-7460
(541) 732-7461
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 732-7460
(541) 732-7460
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
DO154075
OR
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
DO154075
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500634857
MEDICAID
OR
Enumeration date
05/06/2006
Last updated
03/15/2021
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