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
ZIP Code
99362-4445
Phone
(509) 525-3720

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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