NPIMap

Individual provider Active NPI

Charlotte Haws, PA-C

  • Surgical Physician Assistant
  • Tigard, OR
National Provider Identifier
1114285301
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA157890 Issued in OR
Practice address
12123 SW 69TH Ave
Tigard, OR 97223-8514
Phone
(971) 708-7600
Fax
(971) 371-5230
NPI assigned
Apr 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA157890 OR Primary

Addresses

Primary practice location

12123 SW 69TH Ave
Tigard, OR 97223-8514

Mailing address

1498 SE Tech Center PL Ste 240
Vancouver, WA 98683-5508
Phone (360) 597-1313

Other identifiers 2

IdentifierTypeStateIssuer
2018013MedicaidWA
500646365MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120614000725 OR Practitioner - Physician Assistant 9830353218 Reassigns benefits to 2 organizations
I20120913000741 WA Practitioner - Physician Assistant 9830353218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services OregonGroup PAC ID 1557260106, shared by 5 NPIs, 97 clinicians
Northwest Cancer Specialists PCGroup PAC ID 8426943838, 70 clinicians

Practice addresses (Care Compare)

113 S Hwy 101
Warrenton, OR 97146-9314
Phone (503) 861-6500

12123 SW 69TH Ave
Tigard, OR 97223-8514
Phone (971) 708-7600

210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone (360) 944-9889

265 N Broadway
Portland, OR 97227-1800
Phone (503) 280-1223

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Cancer Specialists PC CurrentSince May 19, 2012 Accepting new patients
Legacy Clinics LLC CurrentSince Aug 24, 2015 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Nov 10, 2015 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Nov 10, 2015 Accepting new patients
Northwest Cancer Specialists, PC CurrentSince May 19, 2012 Accepting new patients

Locations

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

265 N Broadway
Portland, OR 97227
Phone (503) 274-4885

12123 SW 69th Ave
Tigard, OR 97223
Phone (971) 708-7600

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

1498 SE Tech Center Pl
Ste 240
Vancouver, WA 98683
Phone (360) 597-1309

210 SE 136th Ave
Vancouver, WA 98684
Phone (360) 944-9889

Interoperability endpoints

  • Direct secure messaging: chaws71070@direct.lhs.org
  • Direct secure messaging: charlotte.haws@compass.ikm.direct-ci.com

Organizations & group practices 7

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

Hospital & facility affiliations 6

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": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1114285301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 240",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835508",
            "telephone_number": "360-597-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12123 SW 69TH AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238514",
            "telephone_number": "971-708-7600",
            "fax_number": "971-371-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWS",
        "first_name": "CHARLOTTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-25",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA157890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2018013",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500646365",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.