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Individual
MRS. BONNIE JEAN HABERZETLE
Active
Individual
MRS. BONNIE JEAN HABERZETLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60317981
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258374
DEPARTMENT OF LABOR AND INDUSTRIES
WA
01
—
258374
L&I
—
05
—
8548190
—
WA
Enumeration date
10/19/2009
Last updated
01/10/2021
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