Basic Information
Provider Information
NPI: 1902338270
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARPER
FirstName: MICHAEL
MiddleName: SPENCER
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3600 LIND AVE SW STE 100
Address2:  
City: RENTON
State: WA
PostalCode: 980574970
CountryCode: US
TelephoneNumber: 4256902715
FaxNumber:  
Practice Location
Address1: 400 S 43RD ST
Address2:  
City: RENTON
State: WA
PostalCode: 980555714
CountryCode: US
TelephoneNumber: 4252283440
FaxNumber: 4256564214
Other Information
ProviderEnumerationDate: 03/28/2017
LastUpdateDate: 08/05/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/05/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD61047372WAN Allopathic & Osteopathic PhysiciansInternal Medicine 
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
208M00000XMD61047372WAY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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