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General NPI Number Information
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NPI Number | 1982722534
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Entity Type | Individual
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Provider Name | RALPH D HAVENS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 3801 150TH AVE SE
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City | BELLEVUE
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State | WA
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Zip | 98006-1668
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Country | US
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Telephone | 425-460-7140
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Fax | 425-460-7129
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Provider Business Mailing Address
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Address Line | PO BOX 34703
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City | SEATTLE
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State | WA
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Zip | 98124-1703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60072857
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License Number State | WA
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