Jackson Lee Haverly in Puyallup - Psychiatry
Jackson Lee Haverly - NPI 1942338785
Jackson Lee Haverly is a Psychiatry in Puyallup, Washington. Jackson Lee Haverly practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for Jackson Lee Haverly is 1942338785. The last update date is 2008-07-29.
Jackson Lee Haverly's current location address is 10611 Canyon Rd E, Puyallup, Washington. You can contact this provider via phone number 2062868352. The mailing address for Jackson Lee Haverly is 10611 Canyon Rd E, Puyallup, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jackson Lee Haverly |
|---|---|
| Address | 10611 Canyon Rd E, Puyallup, Washington |
| Phone Number | 2062868352 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1942338785 |
|---|---|
| Provider Enumeration Date | 2007-03-02 |
| Last Updated Date | 2008-07-29 |
Provider Mailing Address Detail
| Address | 10611 Canyon Rd E |
|---|---|
| City | Puyallup |
| State | Washington (WA) |
| Post Code | 983734256 |
| Phone Number | 2062868352 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | 30718 |
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Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
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What is the unique 10-digit identifier code assigned to Jackson Lee Haverly by the Centers for Medicare & Medicaid Services?
The Jackson Lee Haverly has been issued the NPI (National Provider Identifier) 1942338785 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Jackson Lee Haverly's facilities are geographically located?
The facilities of Jackson Lee Haverly are physically situated at the following location: 10611 Canyon Rd E, Puyallup, WA, 983734256.
What is the Jackson Lee Haverly's specialty and taxonomy code?
The Jackson Lee Haverly's specialty is Psychiatry, and the corresponding taxonomy code is 2084P0800X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1942338785 to Jackson Lee Haverly?
The Centers for Medicare & Medicaid Services originally issued the 1942338785 to Jackson Lee Haverly on 2007-03-02.
As of what date was the information regarding Jackson Lee Haverly, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jackson Lee Haverly, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2008-07-29.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY