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Individual
MARK WESLEY HAFFNER
Active
Individual
MARK WESLEY HAFFNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
1618
MA
363AS0400X
Surgical Physician Assistant
Primary
PA158963
OR
363AS0400X
Surgical Physician Assistant
PA60291947
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982821922
—
WA
05
—
500645833
—
OR
Enumeration date
04/19/2007
Last updated
09/09/2015
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