NPIMap

Individual provider Active NPI

Ewen J Harrison, MD

  • Family Medicine Physician
  • Clackamas, OR
National Provider Identifier
1841647559
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD193244 Issued in OR
Practice address
9290 SE Sunnybrook Blvd Ste 120
Clackamas, OR 97015-6802
Phone
(503) 215-2110
NPI assigned
May 23, 2016
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PG187071 OR
Family Medicine Physician 207Q00000X MD193244 OR Primary

Addresses

Primary practice location

9290 SE Sunnybrook Blvd Ste 120
Clackamas, OR 97015-6802

Mailing address

PO Box 3158
Portland, OR 97208-3158

Other practice location 1

10330 SE 32nd Ave
Ste 250
Milwaukie, OR 97222-6587
Phone (503) 513-8950

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eharrison602691@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190805000782 OR Practitioner - Family Practice 3779877378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of New Mexico School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

9290 SE Sunnybrook Blvd
Suite 120
Clackamas, OR 97015-6802
Phone (503) 215-2110

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
PG187071ORMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services - Oregon Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 1, 2019 Accepting new patients
Providence Health & Services - Oregon Family Medicine Past Accepting new patients

Locations

9290 SE Sunnybrook Blvd
Ste 120
Clackamas, OR 97015
Phone (503) 215-2110

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1841647559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9290 SE SUNNYBROOK BLVD STE 120",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156802",
            "telephone_number": "503-215-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10330 SE 32nd Ave",
            "address_2": "STE 250",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972226587",
            "country_code": "US",
            "telephone_number": "503-513-8950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "EWEN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "PG187071",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD193244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eharrison602691@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9290 SE Sunnybrook Blvd Ste 120",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970156802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.