JACKSON LEE HAVERLY (NPI# 1942338785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942338785 |
| Entity Type | Individual |
| Full Name | JACKSON LEE HAVERLY |
| Credential | M.D. |
| Practice Address |
22410 Benson Rd Se Benson Heights Rehab Center Kent WA 98031-9509 |
| Mailing Address |
10611 Canyon Rd E Pmb 322 Puyallup WA 98373-4256 |
| Practice Telephone | 2062868352 |
| Mailing Telephone | 2062868352 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2008-07-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
00030718 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
22410 BENSON RD SE BENSON HEIGHTS REHAB CENTER |
| City | KENT |
| State | WA |
| Zip Code | 98031-9509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861488280 | Avalon Care Center-kent, LLC | Skilled Nursing Facility | 22410 Benson Rd Se, Kent, WA 98031-9509 | 2005-09-21 |
| 1164920773 | Ellie Feucht | Student in an Organized Health Care Education/Training Program | 22410 Benson Rd Se, Kent, WA 98031-2598 | 2018-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861043325 | Deanna Lila Fuller | Technician | 21417 122nd Place Se, Kent, WA 98031 | 2019-09-26 |
| 1386092054 | Amninder Ripsy Nagra-kaur | Licensed Practical Nurse | 10016 Se 218th Pl, Kent, WA 98031 | 2016-06-02 |
| 1033575113 | Amanda Jane Holen | Nurse Practitioner | 202 State Avenue North, Kent, WA 98031 | 2016-01-05 |
| 1578951281 | Katherine Mitchell | Counselor | 12400 Se 233rd St, Kent, WA 98031 | 2015-01-03 |
| 1376804997 | San Lwai | Internal Medicine | 20040 - 120th Ave S.e., Kent, WA 98031 | 2012-05-30 |
| 1013106822 | Fiorella Andrea Diaz | Interpreter | 20029 104th Place Se, Kent, WA 98031 | 2007-10-17 |
| 1750599361 | Northwest Transport | Non-emergency Medical Transport (VAN) | 22627 85th Pl S, Kent, WA 98031 | 2007-05-18 |
| 1750596953 | Rhonda H. James | Licensed Practical Nurse | 21252 94th Pl. S, Kent, WA 98031 | 2007-05-11 |
| 1124172846 | Jeffrey W Baxter | Counselor | 10024 Se 240th, Suite 116 James Street Building, Kent, WA 98031 | 2007-01-22 |
| 1043398407 | Option 1 Northwest Enteral LLC | Durable Medical Equipment & Medical Supplies | 8633 South 212th Street, Kent, WA 98031 | 2006-11-02 |
| Find all providers in zip 98031 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| 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 disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437536356 | Tetyana Bodnar | Psychiatry & Neurology | 476 S Francis St, Kent, OH 44240-3269 | 2015-04-29 |
| 1144631037 | Sarah E Williamson | Psychiatry & Neurology | 62 Carter Rd, Kent, CT 06757-2740 | 2014-05-13 |
| 1982047247 | Stephanie Armstrong | Psychiatry & Neurology | 325 W Gowe St, Kent, WA 98032-5892 | 2013-04-16 |
| 1386871051 | Brian Pham | Psychiatry & Neurology | 325 W Gowe St, Kent, WA 98032-5892 | 2009-06-19 |
| 1144457243 | Sheetal Pramod Dhoke | Psychiatry & Neurology | 5982 Rhodes Rd, Kent, OH 44240-4128 | 2009-06-16 |
| 1275712549 | Melodie Morgan-minott,md,inc | Psychiatry & Neurology | 401 Devon Pl, Ste 203, Kent, OH 44240-6482 | 2007-11-02 |
| 1093833352 | Parvathi Nanjundiah | Psychiatry & Neurology | 5982 Rhodes Rd, Kent, OH 44240-4128 | 2007-03-26 |
| 1033237300 | Kenneth Scott Pacer | Psychiatry & Neurology | 5982 Rhodes Rd, Kent, OH 44240-4128 | 2007-03-26 |
| 1689791188 | Nita Arora | Psychiatry & Neurology | 5982 Rhodes Rd, Kent, OH 44240-4128 | 2007-03-22 |
| 1578602777 | Mary Ellen Hargrave | Psychiatry & Neurology | 325 W Gowe St, Kent, WA 98032-5892 | 2007-02-05 |
| Find all providers in KENT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.