Provider Demographics
NPI:1134407315
Name:KING, HARRY HC (LAC)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:HC
Last Name:KING
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2505 SE 11TH AVE STE 262
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1062
Mailing Address - Country:US
Mailing Address - Phone:503-406-1003
Mailing Address - Fax:971-200-2409
Practice Address - Street 1:2505 SE 11TH AVE STE 262
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1062
Practice Address - Country:US
Practice Address - Phone:503-406-1003
Practice Address - Fax:971-200-2409
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14290171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist