Cyrus Dale Haskett Jr., LMP
Individual provider Active NPI Homeopath · Ilwaco, WA
NPI 1457628232 · NPPES record last updated Nov 22, 2011
Key facts
- NPI
- 1457628232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homeopath 175L00000X
- License
- MA60246912 (WA)
- Practice address
- 227 Howerton Way SE
Ilwaco, WA 98624-9089 - Phone
- (503) 440-5047
- NPI assigned
- Nov 22, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60246912 | WA | MD | Homeopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Homeopath | 175L00000X | MA60246912 | WA | Yes |
Addresses
Primary practice location
227 Howerton Way SE
Ilwaco, WA 98624-9089
Mailing address
40 Auburn St
Astoria, OR 97103-5606
Phone (503) 440-5047
Other providers in Ilwaco, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.