Individual
PHYLLIS J HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
110 LAKESIDE AVE, SEATTLE, WA 98122-6594
(206) 851-5884
Mailing address
16211 SE 130TH PL, RENTON, WA 98059-8614
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00019335
WA
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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