Active NPI
Andrew Ross Harbison, MD
- Internal Medicine Physician
- Portland, OR
National Provider Identifier
1861400772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 166694MD
- Practice address
- 9512 NE Sacramento St
Portland, OR 97220-4340 - Phone
- (503) 415-1501
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 166694MD | OR | Primary |
Addresses
Primary practice location
9512 NE Sacramento St
Portland, OR 97220-4340
Mailing address
9512 NE Sacramento St
Portland, OR 97220-4340
Phone (503) 255-6402
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 166694 | Other | OR | INTERNAL MEDICINE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166694MD | OR | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611446400000",
"number": "1861400772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9512 NE SACRAMENTO ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972204340",
"telephone_number": "503-255-6402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9512 NE SACRAMENTO ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972204340",
"telephone_number": "503-415-1501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARBISON",
"first_name": "ANDREW",
"middle_name": "ROSS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2021-01-24",
"certification_date": "2020-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OR",
"license": "166694MD",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INTERNAL MEDICINE",
"identifier": "166694",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.