Provider Demographics
NPI:1366632465
Name:WADLEY, HARLAN DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HARLAN
Middle Name:DEAN
Last Name:WADLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 ARDENDALE LN
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1962
Mailing Address - Country:US
Mailing Address - Phone:541-852-3168
Mailing Address - Fax:
Practice Address - Street 1:1627 ARDENDALE LN
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-1962
Practice Address - Country:US
Practice Address - Phone:541-852-3168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD179762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry