Provider Demographics
NPI:1538554761
Name:HAUGSTAD, PATRICK M (RPH)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:M
Last Name:HAUGSTAD
Suffix:
Gender:M
Credentials:RPH
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Other - Credentials:
Mailing Address - Street 1:1330 ROCKEFELLER AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1684
Mailing Address - Country:US
Mailing Address - Phone:425-297-5220
Mailing Address - Fax:425-297-5221
Practice Address - Street 1:1330 ROCKEFELLER AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1684
Practice Address - Country:US
Practice Address - Phone:425-297-5220
Practice Address - Fax:425-297-5221
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPH00014453183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist