Healthcare Provider Details

I. General information

NPI: 1346074788
Provider Name (Legal Business Name): OLIVIA GRACE HARRIS HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E JEFFERSON ST STE 202
SEATTLE WA
98122-5644
US

IV. Provider business mailing address

1600 E JEFFERSON ST STE 202
SEATTLE WA
98122-5644
US

V. Phone/Fax

Practice location:
  • Phone: 206-320-5687
  • Fax:
Mailing address:
  • Phone: 206-320-5687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: