Havers, Courtenay Nicole
Havers, Courtenay Nicole is an individual health care provider with primary practice located at 11307 Bridgeport Way Sw Ste 220A , Lakewood WA 98499-3024. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Havers, Courtenay Nicole can be contacted via phone (253) 985-2733.Contact Information
Primary practice address
11307 Bridgeport Way Sw Ste 220A
Lakewood WA 98499-3024
Phone: (253) 985-2733
Fax: (360) 744-6270
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD00041968 | Washington |
Profile Details
| NPI number | 1619913100 |
|---|---|
| LBN Legal business name | Havers, Courtenay Nicole |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619913100 | NPPES |
| Other | 7405427 | AETNA | |
| Other | P00023573 | AETNA | |
| MEDICAID | 1014702 | AETNA | |
| MEDICAID | 8359416 | AETNA | |
| Other | 8918BR | AETNA | |
| Other | 169190 | AETNA |
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