Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 66209 | MN |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD00042133 | WA |
N | 207YS0123X | Facial Plastic Surgeon | MD00042133 | WA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD00042133 | WA |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD00042133 | WA |
N | 2086X0206X | Surgical Oncologist | MD00042133 | WA |
NPI | 1164496808 |
---|---|
Provider Name | Kevin C Harris |
First Address | Mount Vernon, WA 98274-4127 |
Second Address | Anacortes, WA 98221-2586 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2006 |
Last Update Date | 27/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H84066 | (02) | WA |