Individual
MARK W HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6660
(253) 426-6250
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD0003796
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176574
LIWA
WA
01
—
0176575
LIWA
WA
01
—
0205764
LIWA
WA
01
—
0205765
LIWA
WA
01
—
1126HA
BSWA
WA
01
—
1188HA
BSWA
WA
01
—
1594HA
BSWA
WA
01
—
2169HA
BSWA
WA
01
—
5123HA
BSWA
WA
05
—
8252967
—
WA
05
—
8441529
—
WA
Enumeration date
06/06/2006
Last updated
04/02/2008
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