Organization
STEPHEN A. HABENER, M.D., INC., P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TIA L SMART (OFFICE MANAGER)
(360) 373-2571
Entity
Organization
Contact information
Practice address
2635 WHEATON WAY, BREMERTON, WA 98310-3318
(360) 373-2571
(360) 479-4970
Mailing address
2635 WHEATON WAY, BREMERTON, WA 98310-3318
(360) 373-2571
(360) 479-4970
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00011593
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1340306
—
WA
01
—
A06927
UPIN
WA
Enumeration date
01/27/2012
Last updated
01/27/2012
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