Individual provider Active NPI

Keith Allen Haugen, M.D.

  • Family Medicine Physician
  • Colfax, WA
National Provider Identifier
1104806959
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00042430 Issued in WA
Practice address
1210 W Fairview St
Colfax, WA 99111-9552
Phone
(509) 397-4717
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00042430 WA Primary

Addresses

Primary practice location

1210 W Fairview St
Colfax, WA 99111-9552

Mailing address

1210 W Fairview St
Colfax, WA 99111-9552
Phone (509) 397-4717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070413000288 OR Practitioner - Family Practice 1759317464 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silverton Health 147 clinicians

Practice addresses (Care Compare)

342 Fairview St
Silverton, OR 97381-1917
Phone (503) 525-7660

Hospital & facility affiliations

  • Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029

Merit-based Incentive Payment System (MIPS)

Final score
95.41 of 100Reported as group
Quality
88.83
Promoting interoperability
100
Improvement activities
40
Cost
82.4

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00042430WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Silverton Health Current Accepting new patients
Silverton Health Family Medicine CurrentSince Jun 3, 2015 Accepting new patients
Legacy Clinics LLC CurrentSince Mar 20, 2020 Accepting new patients
Silverton Health CurrentSince Jun 3, 2015 Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Mar 20, 2020 Accepting new patients
St. Mary'S Hospital Inc Family Medicine Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582

347 Fairview St
Silverton, OR 97381
Phone (503) 873-5667

342 Fairview St
Silverton, OR 97381
Phone (503) 525-7660

454 Welch St
Silverton, OR 97381
Phone (503) 873-1722

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1104806959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 W FAIRVIEW ST",
            "city": "COLFAX",
            "state": "WA",
            "postal_code": "991119552",
            "telephone_number": "509-397-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W FAIRVIEW ST",
            "city": "COLFAX",
            "state": "WA",
            "postal_code": "991119552",
            "telephone_number": "509-397-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUGEN",
        "first_name": "KEITH",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00042430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colfax, WA

Sources for this page

Verify at the official NPI Registry.