Stacey Renee Haveman, PHYSICIAN ASSISTANT
NPI #1023309796 in Walla Walla, Washington
Provider Information
- NPI Number
- 1023309796
- Entity Type
- Individual
- Name
- Stacey Renee Haveman, PHYSICIAN ASSISTANT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PHYSICIAN ASSISTANT
- Enumeration Date
- Apr 28, 2011
- Last Updated
- Jan 18, 2016
Practice Location
- Address
- 55 W TIETAN ST
- City
- Walla Walla
- State
- Washington
- ZIP Code
- 99362-4445
- Phone
- (509) 525-3720
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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