Provider Demographics
NPI:1366697310
Name:HARRY A. PIERCE, DO, PS
Entity type:Organization
Organization Name:HARRY A. PIERCE, DO, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:206-244-5805
Mailing Address - Street 1:13014 12TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98146-3110
Mailing Address - Country:US
Mailing Address - Phone:206-244-5805
Mailing Address - Fax:206-248-7362
Practice Address - Street 1:13014 12TH AVE SW
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98146-3110
Practice Address - Country:US
Practice Address - Phone:206-244-5805
Practice Address - Fax:206-248-7362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP0000769261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA15744OtherDEPARTMENT OF LABOR AND INDUSTRIES
WA1294008Medicaid
WAP624OtherREGENCE
WAE32420Medicare UPIN
WA1294008Medicaid