Provider Demographics
NPI:1316396187
Name:HARLAN, MATTHEW ALLEN
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALLEN
Last Name:HARLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 GOODPASTURE LOOP
Mailing Address - Street 2:APT.#11
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-1458
Mailing Address - Country:US
Mailing Address - Phone:541-915-0467
Mailing Address - Fax:
Practice Address - Street 1:4300 GOODPASTURE LOOP
Practice Address - Street 2:APT.# 11
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-1458
Practice Address - Country:US
Practice Address - Phone:541-915-0467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-12
Last Update Date:2016-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist