Gregory A Haveman (NPI# 1447415773, PAC ID# 9931335700) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OTOLARYNGOLOGY.
| Nation Provider ID (NPI) | 1447415773 |
| PAC ID by PECOS | 9931335700 |
| Professional Enrollment ID | I20131126001915 |
| Full Name | Gregory A Haveman |
| Organization Legal Name | WALLA WALLA CLINIC, INC. |
| Address |
320 W Willow St Women's Clinic Walla Walla WA 99362-2922 |
| Phone Number | 5095255010 |
| Gender | M |
| Medical School | UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE |
| Graduation Year | 2008 |
| Primary Specialty | OTOLARYNGOLOGY |
| Group Practice PAC ID | 2264320837 |
| Number of Group Practice Members | 52 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500002 | PROVIDENCE ST MARY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 320 W Willow St, Women's Clinic, Walla Walla, WA 99362-2922 | 5095255010 | WALLA WALLA CLINIC, INC. |
| 55 W Tietan St, Walla Walla, WA 99362-4445 | 50952537201405 | WALLA WALLA CLINIC, INC. |
| Organization Legal Name | WALLA WALLA CLINIC, INC. |
| Physicians | 64 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stacey R Haveman | Physician Assistant | Walla Walla Clinic, Inc. | 55 W Tietan St, Walla Walla, WA 99362-4445 |
| James A Vandersloot | Obstetrics/gynecology | Walla Walla Clinic, Inc. | 320 W Willow St, Women's Clinic, Walla Walla, WA 99362-2922 |
| John G Sislow | Urology | Walla Walla Clinic, Inc. | 10 Ne 5th Ave, Milton Freewater, OR 97862-1702 |
| Justin Olswanger | Family Medicine | Walla Walla Clinic, Inc. | 55 W Tietan St, Walla Walla, WA 99362-4445 |
| Gunnar Leighton James Sjoren | Physical Therapy | Walla Walla Clinic, Inc. | 55 W Tietan St, Walla Walla, WA 99362-4445 |
| Emily Grace Castillo | Nurse Practitioner | Walla Walla Clinic, Inc. | 55 W Tietan St, Walla Walla, WA 99362-4445 |
| Christina R Johanson | Physical Therapy | Walla Walla Clinic, Inc. | 55 W Tietan St, Walla Walla, WA 99362-4445 |
| Jane Scribner | Dermatology | Walla Walla Clinic, Inc. | 55 W Tietan St, Walla Walla, WA 99362-4445 |
| Julie A Wuest | Family Medicine | Walla Walla Clinic, Inc. | 55 W Tietan St, Walla Walla, WA 99362-4445 |
| Kristin K Robinson | Podiatry | Walla Walla Clinic, Inc. | 55 W Tietan St, Walla Walla, WA 99362-4445 |
| Street Address |
320 W WILLOW ST WOMEN'S CLINIC |
| City | WALLA WALLA |
| State | WA |
| Zip | 99362-2922 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| James A Vandersloot | Obstetrics/gynecology | Walla Walla Clinic, Inc. | 320 W Willow St, Women's Clinic, Walla Walla, WA 99362-2922 |
| Kathleen M Burgess | Nurse Practitioner | Walla Walla Clinic, Inc. | 320 W Willow St, Women's Clinic, Walla Walla, WA 99362-2922 |
| Lydia Rosado Rogers | Qualified Audiologist | Walla Walla Clinic, Inc. | 320 W Willow St, Women's Clinic, Walla Walla, WA 99362-2922 |
| Bryony Jo Mccollaugh | Osteopathic Manipulative Medicine | Walla Walla Clinic, Inc. | 320 W Willow St, Women's Clinic, Walla Walla, WA 99362-2922 |
| Claire J Templin | Obstetrics/gynecology | Walla Walla Clinic, Inc. | 320 W Willow St, Women's Clinic, Walla Walla, WA 99362-2922 |
| Malcolm William Hardy | Obstetrics/gynecology | Walla Walla Clinic, Inc. | 320 W Willow St, Women's Clinic, Walla Walla, WA 99362-2922 |
| Cynthia B Reese | Certified Nurse Midwife | Walla Walla Clinic, Inc. | 320 W Willow St, Women's Clinic, Walla Walla, WA 99362-2922 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cynthia A Wallace | Clinical Social Worker | 19 E Birch, Suite 103, Walla Walla, WA 99362 | |
| Susan L Stough | Clinical Social Worker | 409 E Sumach St, Suite 6, Walla Walla, WA 99362-1202 | |
| Natasha Anne Rustad | Clinical Social Worker | 409 E Sumach St, Rustad Counseling LLC, Walla Walla, WA 99362-1202 | |
| Pavel S Blagov | Clinical Psychologist | 409 E Sumach St, Suite 3, Walla Walla, WA 99362-1202 | |
| Robert L Stough Jr. | Psychologist, Clinical | 409 E Sumach St, Walla Walla, WA 99362-1228 | |
| Chance Higginbotham | Chiropractic | 2200 Melrose St, 7a, Walla Walla, WA 99362-1579 | |
| Alayna M Brinton | Clinical Social Worker | 2330 Eastgate St, Suite 140, Walla Walla, WA 99362-1589 | |
| Sean Thomas Duffy | Family Medicine | Yakima Valley Farm Workers Clinic | 1120 W Rose St, Walla Walla, WA 99362-1662 |
| Bradley K Nielson | Optometry | 208 N 2nd Ave, Walla Walla, WA 99362-1806 | |
| Eric John Wiessner | Optometry | 614 E Alder St, Suite 1, Walla Walla, WA 99362-2073 | |
| Find all physicians in zip 99362 | |||
| City | WALLA WALLA |
| Zip Code | 99362 |
| Specialty | OTOLARYNGOLOGY |
| City + Specialty | WALLA WALLA + OTOLARYNGOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.