| Amy Harris Psyd | |
|
814 Ne 63rd Ave Portland OR 97213-4338 | |
| (802) 238-5337 | |
| Not Available |
| Full Name | Amy Harris Psyd |
|---|---|
| Speciality | Psychologist |
| Location | 814 Ne 63rd Ave, Portland, Oregon |
| Authorized Official Name and Position | Amy Harris (SOLE MEMBER) |
| Authorized Official Contact | 8022385337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Harris Psyd 814 Ne 63rd Ave Portland OR 97213-4338 Ph: () - | Amy Harris Psyd 814 Ne 63rd Ave Portland OR 97213-4338 Ph: (802) 238-5337 |
| NPI Number | 1780351114 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 08/24/2021 |
| Certification Date | 08/24/2021 |
| Medicare PECOS PAC ID | 1254737505 |
|---|---|
| Medicare Enrollment ID | O20210910002981 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780351114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amy L Harris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427161587 PECOS PAC ID: 7911904214 Enrollment ID: I20190920001670 |
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