Alan O Haakenstad, MD.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD00012063 Issued in WA

Practice address

12800 Bothell Everett Hwy
Suite180
Everett, WA 98208-6642

Phone

(425) 316-5130

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1730136367
  Medicare reassignment NPD
• Community Health Center of Snohomish County

  • Federally Qualified Health Center (FQHC)
  • Everett, WA
  • NPI 1023830346
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1659304558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-366-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 BOTHELL EVERETT HWY",
            "address_2": "SUITE180",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086642",
            "telephone_number": "425-316-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAKENSTAD",
        "first_name": "ALAN",
        "middle_name": "O",
        "credential": "MD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00012063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8127938",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Rob Guyer, MD
• Leora Gwin, HS-BCP, CADC, CPS
• Carter Gwinn
• Peggy Ann Gwinn, CDP
• Kimberly Ha, ARNP
• Amanda Marie Habben
• Polly J Haberlin, MD
• Linda Hadaway, AAC, CDP
• Ross Alan Haddow, D.D.S.
• Elizabeth Joy Hadley, PA-C

• Nephrology Physician in Everett, WA
• Providers in Everett, WA by specialty
• Nephrology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.