Active NPI
Theodore Edward Harrison, M.D.
- General Practice Physician
- Port Angeles, WA
National Provider Identifier
1285013391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- MD00040509
- Practice address
- 109 N Oak St
Port Angeles, WA 98362-2616 - Phone
- (360) 207-4727
- NPI assigned
- May 21, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | MD00040509 | WA | Primary |
Addresses
Primary practice location
109 N Oak St
Port Angeles, WA 98362-2616
Mailing address
109 N Oak St
Port Angeles, WA 98362-2616
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00040509 | WA | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baltimore Washington Emergency Physicians, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Glen Burnie, MD
- NPI 1215983853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432166400000",
"number": "1285013391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 N OAK ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983622616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 N OAK ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983622616",
"telephone_number": "360-207-4727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "THEODORE",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-21",
"last_updated": "2015-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WA",
"license": "MD00040509",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Angeles, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.