Individual provider Active NPI

Laurel R Harris, MD

  • Ophthalmology Physician
  • Puyallup, WA
National Provider Identifier
1760587612
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD00029429 Issued in WA
Practice address
1703 S Meridian
Suite 101
Puyallup, WA 98371-7590
Phone
(253) 848-3000
Fax
(253) 840-6514
NPI assigned
Sep 14, 2006
Last updated
Jan 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD00029429 WA Primary

Addresses

Primary practice location

1703 S Meridian
Suite 101
Puyallup, WA 98371-7590

Mailing address

1703 S Meridian
Suite 101
Puyallup, WA 98371-7590
Phone (253) 848-3000

Other identifiers 1

IdentifierTypeStateIssuer
8140170MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041220000294 WA Practitioner - Ophthalmology 7719874825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00029429WAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Eye & Skin Centers P.C. Ophthalmology CurrentSince Oct 1, 1994 Accepting new patients

Locations

205 10th St NE
Ste 119
Auburn, WA 98002
Phone (253) 939-7911

4907 Point Fosdick Dr
Ste E700
Gig Harbor, WA 98335

1703 S Meridian
Ste 101
Puyallup, WA 98371
Phone (253) 770-7708

5225 Cirque Dr W
University Place, WA 98467
Phone (253) 564-3365

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1760587612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN",
            "address_2": "SUITE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-848-3000",
            "fax_number": "253-840-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S MERIDIAN",
            "address_2": "SUITE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983717590",
            "telephone_number": "253-848-3000",
            "fax_number": "253-840-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LAUREL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00029429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8140170",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.