KENNETH A HAVERLAND PA-C NPI 1487842761

NPI Information

  • NPI: 1487842761
  • Provider Name: KENNETH A HAVERLAND, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1959 NE PACIFIC ST STE AA115
    BOX # 356310
    SEATTLE, WA
    ZIP 98195
  • Phone: (206) 543-3093

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NPI Details

Kenneth A Haverland, PA-C is a surgical physician assistant in Seattle, WA. Kenneth A Haverland, PA-C NPI is 1487842761. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1959 NE PACIFIC ST STE AA115
BOX # 356310
SEATTLE, WA
ZIP 98195-001
Phone: (206) 543-3093
Fax: (206) 543-0325

The NPI 1487842761 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 enumeration date for this NPI number is 10/11/2007 and was last updated on 6/14/2008.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantPA10005309WASHINGTONNo
2363AS0400XPhysician AssistantSurgicalPA10005309WASHINGTONYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18869235MEDICARE PINWASHINGTON

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: 11/21/2025

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