Individual
KEITH AUSTIN HAVENSTRITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
314 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4250
(253) 403-7257
Mailing address
314 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4250
(253) 403-7257
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
041053
GA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD60132453
WA
Other
Enumeration date
12/05/2006
Last updated
01/22/2016
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