Individual
KENNETH A HAVERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1959 NE PACIFIC ST STE AA115, BOX # 356310, SEATTLE, WA 98195-0001
(206) 543-3093
(206) 543-0325
Mailing address
1959 NE PACIFIC ST STE AA115, BOX # 356310, SEATTLE, WA 98195-0001
(206) 543-3093
(206) 543-0325
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA10005309
WA
363AS0400X
Surgical Physician Assistant
Primary
PA10005309
WA
Other
Enumeration date
10/11/2007
Last updated
06/14/2008
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