STACEY RENEE HAVEMAN

WALLA WALLA, WA
NPI1023309796
Former NameSTACEY RENEE COWAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: WA  PA60389054)
Enumeration Date2011-04-28
Last Update Date2016-01-18
Business Address
-- STACEY RENEE HAVEMAN Physician Assistant
55 W TIETAN ST
WALLA WALLA, WA 99362-4445
Phone number: 509-525-3720
Mailing Address
-- STACEY RENEE HAVEMAN Physician Assistant
55 W TIETAN ST
WALLA WALLA, WA 99362-4445
Phone number: 509-525-3720
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