Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | M-8564 | ID |
N | 208600000X | Surgeon | M-8564 | ID |
Y | 208200000X | Surgeon | MD60088259 | WA |
Y | 208600000X | Surgeon | MD60088259 | WA |
NPI | 1003980764 |
---|---|
Provider Name | Eric A Harris |
First Address | Kirkland, WA 98034-1223 |
Second Address | Lynnwood, WA 98036-4869 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 19/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD60088259 | STATE LICENSE (01) | WA |