Provider Demographics
NPI:1194196857
Name:HARPER, MEREDITH JUNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:JUNE
Last Name:HARPER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:JUNE
Other - Last Name:KARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:4409 NW ANDERSON HILL RD
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-6807
Mailing Address - Country:US
Mailing Address - Phone:360-698-6630
Mailing Address - Fax:360-698-7002
Practice Address - Street 1:4409 NW ANDERSON HILL RD
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-6807
Practice Address - Country:US
Practice Address - Phone:360-698-6630
Practice Address - Fax:360-698-7002
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60606831363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2049642Medicaid