Provider Demographics
NPI:1548785256
Name:HARRACH, HANK BOCEPHUS
Entity Type:Individual
Prefix:
First Name:HANK
Middle Name:BOCEPHUS
Last Name:HARRACH
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 1:2504 OAKMONT WAY STE A
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-5543
Mailing Address - Country:US
Mailing Address - Phone:541-334-5000
Mailing Address - Fax:541-334-5000
Practice Address - Street 1:2504 OAKMONT WAY STE A
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5543
Practice Address - Country:US
Practice Address - Phone:541-334-5000
Practice Address - Fax:541-334-5000
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR023308225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist