Individual
JAROM DANIEL HAYWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA61495713
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA61495713
DEPT. OF HEALTH
WA
Enumeration date
08/29/2022
Last updated
02/01/2024
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