Active NPI
Mary Harris-Tucker, PA-C
- Medical Physician Assistant
- Tacoma, WA
National Provider Identifier
1811033202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10003442
- Practice address
- 1717 S J St
Tacoma, WA 98405-4933 - Phone
- (253) 426-6341
- Fax
- (253) 426-6344
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10003442 | WA | Primary |
Addresses
Primary practice location
1717 S J St
Tacoma, WA 98405-4933
Mailing address
1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0259108 | Other | WA | STATE L&I |
| 6718HA | Other | WA | REGENCE |
| 193948 | Other | VA | LABOR & INDUSTRIES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Medical Group | 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.
-
- Neurological Surgery Physician
- Federal Way, WA
- NPI 1386857530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1811033202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 S J ST",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054933",
"telephone_number": "253-426-6341",
"fax_number": "253-426-6344"
},
{
"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": "253-426-6341",
"fax_number": "253-426-6344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS-TUCKER",
"first_name": "MARY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10003442",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE L&I",
"identifier": "0259108",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "6718HA",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "193948",
"state": "VA"
}
],
"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 Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.