Individual provider Active NPI

Olivia Stephanie Haesloop, MD

  • Emergency Medicine Physician
  • Port Townsend, WA
National Provider Identifier
1386910420
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD.60493095 Issued in WA
Practice address
834 Sheridan St
Port Townsend, WA 98368-2443
Phone
(360) 385-2200
NPI assigned
Mar 22, 2012
Last updated
Jan 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD.60493095 WA Primary

Addresses

Primary practice location

834 Sheridan St
Port Townsend, WA 98368-2443

Mailing address

834 Sheridan St
Port Townsend, WA 98368-2443
Phone (603) 852-2003

Other practice location 1

939 Caroline St
Port Angeles, WA 98362-3909
Phone (360) 417-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160804002469 WA Practitioner - Emergency Medicine 2466771456 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Perelman School of Med at the University of Pennsylvania, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 385-2200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.60493095WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Public Hospital District No 2 CurrentSince Dec 12, 2022 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Dec 12, 2022 Accepting new patients
Peacehealth Current Accepting new patients

Locations

1117 Spring St
Friday Harbor, WA 98250
Phone (360) 378-1738

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

1274 7th St
#A
Port Townsend, WA 98368
Phone (360) 385-2204

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

934 Sheridan St
Port Townsend, WA 98368
Phone (360) 385-5330

Organizations & group practices 3

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 3

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": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1386910420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682443",
            "telephone_number": "603-852-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682443",
            "telephone_number": "360-385-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "939 Caroline St",
            "address_purpose": "LOCATION",
            "city": "Port Angeles",
            "state": "WA",
            "postal_code": "983623909",
            "country_code": "US",
            "telephone_number": "360-417-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAESLOOP",
        "first_name": "OLIVIA",
        "middle_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD.60493095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

Verify at the official NPI Registry.