1881923795 NPI number — MS. APRIL JOY HAUGEN MSM, LM, CPM

Table of content: MS. APRIL JOY HAUGEN MSM, LM, CPM (NPI 1881923795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881923795 NPI number — MS. APRIL JOY HAUGEN MSM, LM, CPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAUGEN
Provider First Name:
APRIL
Provider Middle Name:
JOY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSM, LM, CPM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BONHAM
Provider Other First Name:
APRIL
Provider Other Middle Name:
JOY
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSM, LM, CPM
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1881923795
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 N ANDERSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLENSBURG
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98926-3148
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-775-6774
Provider Business Mailing Address Fax Number:
360-841-7417

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 N ANDERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLENSBURG
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98926-3148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-775-6774
Provider Business Practice Location Address Fax Number:
360-841-7417
Provider Enumeration Date:
12/24/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 374J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: MW60388741 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2043444 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".