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NPI Code Detail

MEDICARE: MR. KRISTIAN THOMAS WORKMAN HASKINS HIS

MEDICARE: MR. KRISTIAN THOMAS WORKMAN HASKINS HIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument SpecialistHA60680306WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HA60680306OTHERWAHEARING AID SPECIALIST LICENSE

General Provider Information

NPI Number : 1952822660
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KRISTIAN THOMAS WORKMAN HASKINS HIS
Provider Business Mailing Address
First Line : PO BOX 600
Second Line :
City : MANCHESTER
State : WA
Zip : 98353-0600
Country : US
Telephone Number : 360-710-4450
Fax Number :
Provider Business Practice Location Address
First Line : 1328 COLCHESTER DRIVE S.E.
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366
Country : US
Telephone Number : 360-710-4450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2017
Last Update Date : 06/16/2018

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