Healthcare Provider Details

I. General information

NPI: 1740503994
Provider Name (Legal Business Name): MARGARET C HARRISON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2010
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10452 SILVERDALE WAY NW
SILVERDALE WA
98383-9411
US

IV. Provider business mailing address

1608 S J ST FL 3
TACOMA WA
98405-4930
US

V. Phone/Fax

Practice location:
  • Phone: 360-307-7300
  • Fax: 360-307-7304
Mailing address:
  • Phone: 253-274-7503
  • Fax: 253-351-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60565196
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110003254
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA60565196
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: