Individual
MARK DAVID HAUGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 WEST TIETAN STREET, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1592
Mailing address
55 WEST TIETAN STREET, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1592
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35.082702
OH
207Q00000X
Family Medicine Physician
Primary
MD60024498
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2425736
—
OH
Enumeration date
07/28/2006
Last updated
12/10/2008
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