NPIMap

Individual provider Active NPI

Stephanie A Mack Harmon

  • Physician Assistant
  • Redmond, WA
National Provider Identifier
1295182574
Registry record updated Dec 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60795287 Issued in WA
Practice address
8980 161St Ave NE Ste 320
Redmond, WA 98052-7554
Phone
(425) 883-3333
Fax
(425) 869-4854
NPI assigned
May 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA60795287 WA Primary

Addresses

Primary practice location

8980 161St Ave NE Ste 320
Redmond, WA 98052-7554

Mailing address

8980 161St Ave NE Ste 320
Redmond, WA 98052-7554
Phone (425) 883-3333

Other practice location 1

4311 11th Ave NE
Suite 200
Seattle, WA 98105-6366
Phone (206) 616-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171122001802 WA Practitioner - Physician Assistant 4385901651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Nov 1, 2017 Accepting new patients
Providence Health & Services - Wa CurrentSince Jul 1, 2022 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Nov 1, 2017 Accepting new patients
Providence Health & Services- Washington CurrentSince Jul 1, 2022 Accepting new patients
Providence Health & Services-Wa Past Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

8980 161st Ave NE
Ste 320
Redmond, WA 98052
Phone (425) 823-4000

Interoperability endpoints

  • Direct secure messaging: smackharmon2421014@wm.providencedirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1295182574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8980 161ST AVE NE STE 320",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527554",
            "telephone_number": "425-883-3333",
            "fax_number": "425-869-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8980 161ST AVE NE STE 320",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980527554",
            "telephone_number": "425-883-3333",
            "fax_number": "425-869-4854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056366",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "fax_number": "206-616-3889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACK HARMON",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60795287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.