Individual
COURTENAY NICOLE HAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
(360) 782-3400
(360) 782-3450
Mailing address
9621 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8502
(360) 782-3400
(360) 782-3450
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00041968
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014702
—
WA
01
—
169190
LABOR AND INDUSTRIES
WA
01
—
7405427
AETNA
—
05
—
8359416
—
WA
01
—
8918BR
REGENCE BLUESHIELD
—
01
—
P00023573
RAILROAD MEDICARE
—
Enumeration date
06/22/2006
Last updated
11/08/2024
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