Provider Demographics
NPI:1558543785
Name:HARARI, DENISE J (LMP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:J
Last Name:HARARI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 ALBION PARVIN RD
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-8794
Mailing Address - Country:US
Mailing Address - Phone:509-998-3229
Mailing Address - Fax:
Practice Address - Street 1:3402 ALBION PARVIN RD
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-8794
Practice Address - Country:US
Practice Address - Phone:509-998-3229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020540172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker