Individual
MS. THERESA J HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1706 S MERIDIAN STE 130, PUYALLUP, WA 98371-7516
(253) 848-8797
(253) 845-1114
Mailing address
1706 S MERIDIAN STE 130, PUYALLUP, WA 98371-7516
(253) 848-8797
(253) 845-1114
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP30006868
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4307205
—
MT
05
—
807332000
—
ID
05
—
9647132
—
WA
Enumeration date
07/17/2006
Last updated
05/26/2016
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