Provider Demographics
NPI:1659721280
Name:HARKNESS, BROOKE MORRIS (OD)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:MORRIS
Last Name:HARKNESS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:KATHLEEN
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3303 SW BOND AVE
Mailing Address - Street 2:MAIL CODE CH11P
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4501
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15298 SW ROYALTY PKWY
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97224-3904
Practice Address - Country:US
Practice Address - Phone:503-227-2020
Practice Address - Fax:503-598-9661
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3663ATI152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management