Healthcare Provider Details

I. General information

NPI: 1952879397
Provider Name (Legal Business Name): MAGDALENA J HAIGH ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2018
Last Update Date: 12/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1326 N STANFORD LN
LIBERTY LAKE WA
99019-5034
US

IV. Provider business mailing address

PO BOX 3649
SPOKANE WA
99220-3649
US

V. Phone/Fax

Practice location:
  • Phone: 509-838-2531
  • Fax: 509-755-6580
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60914399
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: