Individual provider Active NPI

Phillip Wayne Harris, LMP

  • Reflexologist
  • Liberty Lake, WA
National Provider Identifier
1043559446
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ReflexologistTaxonomy code 173C00000X
License
MA60294803 Issued in WA
Practice address
E 23505 Appleway
Liberty Lake, WA 99019
Phone
(503) 789-8651
Fax
(509) 210-5289
NPI assigned
Feb 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reflexologist 173C00000X MA60294803 WA Primary

Addresses

Primary practice location

E 23505 Appleway
Liberty Lake, WA 99019

Mailing address

E 23505 Appleway
Liberty Lake, WA 99019
Phone (503) 789-8651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA60294803WAMDReflexologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1043559446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E 23505 APPLEWAY",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "99019",
            "telephone_number": "503-789-8651",
            "fax_number": "509-210-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E 23505 APPLEWAY",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "99019",
            "telephone_number": "503-789-8651",
            "fax_number": "509-210-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "PHILLIP",
        "middle_name": "WAYNE",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-05",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "WA",
            "license": "MA60294803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.