Provider Demographics
NPI:1477192318
Name:HARWOOD, ROD PAUL
Entity Type:Individual
Prefix:
First Name:ROD
Middle Name:PAUL
Last Name:HARWOOD
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 1:914 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-1324
Mailing Address - Country:US
Mailing Address - Phone:541-969-2129
Mailing Address - Fax:
Practice Address - Street 1:914 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-1324
Practice Address - Country:US
Practice Address - Phone:541-969-2129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health