Provider Demographics
NPI:1811713357
Name:HARSHMAN, JUSTIN (PA)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:HARSHMAN
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:16906 NE 101ST PL
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3143
Mailing Address - Country:US
Mailing Address - Phone:425-894-7660
Mailing Address - Fax:
Practice Address - Street 1:14650 AVIATION BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-6667
Practice Address - Country:US
Practice Address - Phone:323-268-6731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-30
Last Update Date:2024-11-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant