Individual
KHADIDJA LATISE HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
690 BARNES BLVD, JOINT BASE LEWIS MCCHORD, WA 98438-1303
(253) 982-5688
Mailing address
505 BROADWAY UNIT 700, TACOMA, WA 98402-3997
(808) 745-7109
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
60935910
WA
Other
Enumeration date
05/16/2008
Last updated
02/02/2026
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