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1194836528

NPI Code Detail

MEDICARE: DR. KEITH W HARPER M.D.

MEDICARE: DR. KEITH W HARPER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085B0100X	Body Imaging Physician	200300801	NC
2	2085P0229X	Pediatric Radiology Physician	200300801	NC
3	2085N0700X	Neuroradiology Physician	200300801	NC
4	2085N0904X	Nuclear Radiology Physician	200300801	NC
5	2085R0203X	Therapeutic Radiology Physician	200300801	NC
6	2085R0204X	Vascular & Interventional Radiology Physician	200300801	NC
7	2085R0202X	Diagnostic Radiology Physician	200300801	NC
8	2085R0205X	Radiological Physics Physician	200300801	NC
9	2085U0001X	Diagnostic Ultrasound Physician	200300801	NC
10	2085R0202X	Diagnostic Radiology Physician	MD61477115	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00124917	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	560941927	OTHER	NC	UNITED HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	560941927	OTHER	NC	CIGNA
4	560941927	OTHER	NC	MEDCOST
6	134UE	OTHER	NC	BCBS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	246190	OTHER	NC	MAMSI

General Provider Information

NPI Number	:	1194836528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEITH W HARPER M.D.

Provider Business Mailing Address
First Line	:	19020 33RD AVE W STE 210
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-4748
Country	:	US
Telephone Number	:	425-563-1500
Fax Number	:	425-563-1374

Provider Business Practice Location Address
First Line	:	2409 N 45TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-6907
Country	:	US
Telephone Number	:	206-633-8100
Fax Number	:	206-632-1657

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/22/2024

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Directions to “ DR. KEITH W HARPER M.D.” Practice Location

Language	Start Address	Practice Location

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