Individual provider Active NPI

Michael Anthony Harris, MD

  • Hematology & Oncology Physician
  • Puyallup, WA
National Provider Identifier
1932245644
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
MD60082175 Issued in WA
Practice address
400 15TH Ave SE
Puyallup, WA 98372-3750
Phone
(253) 697-1310
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X G47100 CA
Hematology & Oncology Physician 207RH0003X MD60082175 WA Primary

Addresses

Primary practice location

400 15TH Ave SE
Puyallup, WA 98372-3750

Mailing address

400 15TH Ave SE
Puyallup, WA 98372-3750
Phone (253) 697-1310

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
I20090820000039 WA Practitioner - Hematology/OncologyPractitioner - Internal Medicine 8628122033 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G47100CAMDHematology & Oncology Physician
MD60082175WAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Nov 5, 2012 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Nov 5, 2012 Accepting new patients
Providence Medical Foundation Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

400 15th Ave SE
Puyallup, WA 98372
Phone (253) 697-1310

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: mharris110673@direct.multicare.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349654400000",
    "number": "1932245644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 15TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723750",
            "telephone_number": "253-697-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 15TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723750",
            "telephone_number": "253-697-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "G47100",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WA",
            "license": "MD60082175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.