Provider Demographics
NPI:1770803298
Name:HARRIS, NAHAM MCCAIN (LMP)
Entity type:Individual
Prefix:
First Name:NAHAM
Middle Name:MCCAIN
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 XENIA LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-3864
Mailing Address - Country:US
Mailing Address - Phone:360-739-9846
Mailing Address - Fax:
Practice Address - Street 1:1115 N STATE ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5076
Practice Address - Country:US
Practice Address - Phone:360-739-9846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60142179172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist