| Harkness Medical Group, Pllc | |
|
412 Black Hills Ln Sw Ste A Olympia WA 98502-8142 | |
| (360) 567-6064 | |
| (833) 731-0392 |
| Full Name | Harkness Medical Group, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 412 Black Hills Ln Sw Ste A, Olympia, Washington |
| Authorized Official Name and Position | Ross Harkness (OWNER) |
| Authorized Official Contact | 7854105472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harkness Medical Group, Pllc 412 Black Hills Ln Sw Ste A Olympia WA 98502-8142 Ph: (360) 567-6064 | Harkness Medical Group, Pllc 412 Black Hills Ln Sw Ste A Olympia WA 98502-8142 Ph: (360) 567-6064 |
| NPI Number | 1215518113 |
|---|---|
| Provider Enumeration Date | 04/21/2021 |
| Last Update Date | 10/27/2021 |
| Medicare PECOS PAC ID | 5698175669 |
|---|---|
| Medicare Enrollment ID | O20210611002609 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215518113 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kellie Anne Harkness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720541683 PECOS PAC ID: 4284062142 Enrollment ID: I20200309000697 |
| Provider Name | Yesenia Chavarin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306441415 PECOS PAC ID: 6103227079 Enrollment ID: I20210629002871 |
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