Michael Dean Harris, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY00000830 Issued in WA

Practice address

15436 Bel Red Rd
Ste 100
Redmond, WA 98052-5536

Phone

(425) 644-4100

Fax

(425) 644-4101

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1245347525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 140TH AVE NE",
            "address_2": "STE E110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051862",
            "telephone_number": "425-644-4100",
            "fax_number": "425-644-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15436 BEL RED RD",
            "address_2": "STE 100",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525536",
            "telephone_number": "425-644-4100",
            "fax_number": "425-644-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00000830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0050745",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8349235",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Redmond, WA
• Providers in Redmond, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.