Individual
CYRUS DALE HASKETT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
227 HOWERTON WAY SE, ILWACO, WA 98624-9089
(503) 440-5047
Mailing address
40 AUBURN ST, ASTORIA, OR 97103-5606
(503) 440-5047
Taxonomy
Speciality
Code
Description
License number
State
175L00000X
Homeopath
Primary
MA60246912
WA
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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