Active NPI
Mark W Harris, MD
- Emergency Medicine Physician
- Tacoma, WA
National Provider Identifier
1699714295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD0003796
- Practice address
- 1717 S J St
Tacoma, WA 98405-4933 - Phone
- (253) 426-6660
- Fax
- (253) 426-6250
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD0003796 | WA | Primary |
Addresses
Primary practice location
1717 S J St
Tacoma, WA 98405-4933
Mailing address
505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2169HA | Other | WA | BSWA |
| 0205765 | Other | WA | LIWA |
| 1188HA | Other | WA | BSWA |
| 5123HA | Other | WA | BSWA |
| 8252967 | Medicaid | WA | |
| 0176574 | Other | WA | LIWA |
| 0205764 | Other | WA | LIWA |
| 1126HA | Other | WA | BSWA |
| 8441529 | Medicaid | WA | |
| 0176575 | Other | WA | LIWA |
| 1594HA | Other | WA | BSWA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD0003796 | WA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Physician Associates, Apc | Emergency Medicine | 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
- Federal Way, WA
- NPI 1407127442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207094400000",
"number": "1699714295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 S 336TH ST",
"address_2": "SUITE 600",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036328",
"telephone_number": "253-838-6180",
"fax_number": "253-838-6418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S J ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054933",
"telephone_number": "253-426-6660",
"fax_number": "253-426-6250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "MARK",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2008-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WA",
"license": "MD0003796",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "2169HA",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0205765",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "1188HA",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "5123HA",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8252967",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0176574",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0205764",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "1126HA",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8441529",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIWA",
"identifier": "0176575",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSWA",
"identifier": "1594HA",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.