Provider Demographics
NPI:1194722827
Name:GRIFFITH, HARRY S III (MD)
Entity type:Individual
Prefix:MR
First Name:HARRY
Middle Name:S
Last Name:GRIFFITH
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34439
Mailing Address - Street 2:STE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124
Mailing Address - Country:US
Mailing Address - Phone:425-525-6717
Mailing Address - Fax:425-525-6700
Practice Address - Street 1:4525 3RD AVE SE
Practice Address - Street 2:STE 200
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1010
Practice Address - Country:US
Practice Address - Phone:360-754-3934
Practice Address - Fax:360-943-8023
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00028284174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8128969Medicaid
WAE99266Medicare UPIN
WA8128969Medicaid