Mark Wesley Haffner, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA158963 Issued in OR

Practice address

2222 NW Lovejoy St
Suite 315
Portland, OR 97210-5101

Phone

(503) 226-6321

Fax

(503) 227-3422

NPI assigned

Apr 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mhaffner71536@direct.lhs.org

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.

• The Oregon Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • Portland, OR
  • NPI 1346105129
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1982821922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "address_2": "SUITE 315",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105101",
            "telephone_number": "503-226-6321",
            "fax_number": "503-227-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NW LOVEJOY ST",
            "address_2": "SUITE 315",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972105101",
            "telephone_number": "503-226-6321",
            "fax_number": "503-227-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFFNER",
        "first_name": "MARK",
        "middle_name": "WESLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "1618",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA158963",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60291947",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982821922",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500645833",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Louise Haener
• Krisanne Haerr, L.P.C.
• Barbara Hafdahl, LMHC
• Darrell Hafer
• Arthur Travis Haffey, R-PAC
• Carley Haft, MD
• Brandy Elaine Hagan, D.C.
• Stephani Hagberg
• Bradley R Hagedorn, DMD
• Gunny Hagelberg-Cherrytree, CRNA

• Surgical Physician Assistant in Portland, OR
• Providers in Portland, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.