Healthcare Provider Details

I. General information

NPI: 1023049343
Provider Name (Legal Business Name): LANCE A HARRIS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 E J ST
TACOMA WA
98404-3220
US

IV. Provider business mailing address

3001 E J ST
TACOMA WA
98404-3220
US

V. Phone/Fax

Practice location:
  • Phone: 253-274-9733
  • Fax: 253-274-9733
Mailing address:
  • Phone: 253-274-9733
  • Fax: 253-274-9733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY00000428
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY00000428
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: