Kenneth A Haverland, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA10005309 Issued in WA

Practice address

1959 NE Pacific St Ste Aa115
Box # 356310
Seattle, WA 98195-0001

Phone

(206) 543-3093

Fax

(206) 543-0325

NPI assigned

Oct 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Association of CHMC and University Physicians

  • Pediatrics Physician
  • Richland, WA
  • NPI 1851680664
  NPD
• Seattle Children'S Hospital

  • Children's Hospital
  • Seattle, WA
  • NPI 1467536276
  NPD
• Seattle Childrens Hospital

  • Clinic Pharmacy
  • Seattle, WA
  • NPI 1245342153
  NPD
• The Association of Chrmc and University Physicians

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1255449963
  NPD
• Bourget Health Services Inc

  • Clinical Medical Laboratory
  • Spokane, WA
  • NPI 1033117338
  NPD (past)
• Public Hospital District 1 of King County

  • Institutional Pharmacy
  • Renton, WA
  • NPI 1679862189
  NPD (past)

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213401600000",
    "number": "1487842761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST STE AA115",
            "address_2": "BOX # 356310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-543-3093",
            "fax_number": "206-543-0325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST STE AA115",
            "address_2": "BOX # 356310",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-543-3093",
            "fax_number": "206-543-0325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERLAND",
        "first_name": "KENNETH",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-11",
        "last_updated": "2008-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005309",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10005309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Kay Havens, M.A., LMHC
• Deborah J Havens, DO
• Jesse Rochelle Havens, RN
• Spencer R Havens, MD
• Nancy Haver, MA, LMHCA
• Leigh Haverstick, RRT
• Jennifer Lee Havlin
• Havn Healing Center, PLLC
• John Hardin Hawes, MD
• Kristina Jean Hawes, MSW

• Surgical Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.