Provider Type Icon

STACEY RENEE HAVEMAN PHYSICIAN ASSISTANT NPI 1023309796


NPI Information

NPI: 1023309796
Provider Name: STACEY RENEE HAVEMAN, PHYSICIAN ASSISTANT
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
55 W TIETAN ST
WALLA WALLA, WA
ZIP 99362
Phone: (509) 525-3720
Get Directions

Stacey Renee Haveman, PHYSICIAN ASSISTANT is a medical physician assistant in Walla Walla, WA with 14 years of experience. Stacey Renee Haveman, PHYSICIAN ASSISTANT NPI is 1023309796. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

55 W TIETAN ST
WALLA WALLA, WA
ZIP 99362-445
Phone: (509) 525-3720
Fax: (509) 522-1592

The NPI 1023309796 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, triamcinolone acetonide, not otherwise specified, 10 mg (HCPCS:J3301)
  • Aspiration and/or injection of large joint or joint capsule (HCPCS:20610)
  • Repair of knee joint (HCPCS:27447)
  • Injections of tendon sheath, ligament, or muscle membrane (HCPCS:20550)

The enumeration date for this NPI number is 4/28/2011 and was last updated on 1/18/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363AM0700XPhysician AssistantMedicalPA60389054WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
103465758MEDICAIDNEW YORK
2J400045859MEDICARE PINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.