Stacey Renee Haveman, PHYSICIAN ASSISTANT
Medical Physician Assistant · Walla Walla, WA
Stacey Renee Haveman, PHYSICIAN ASSISTANT is a medical physician assistant with a practice address in Walla Walla, Washington, and NPI 1023309796, issued on Apr 28, 2011. Check the license (Washington PA60389054, as entered in NPPES) with the Washington board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Stacey Renee Haveman
- Credential
- PHYSICIAN ASSISTANT
- Primary taxonomy
- Medical Physician Assistant 363AM0700X
- License number
- PA60389054 WA
Self-reported in NPPES; status is on the state search - Practice location
- 55 W Tietan St, Walla Walla, WA 99362
- Phone
- (509) 525-3720
- Enumerated
- Apr 28, 2011
- Record last updated
- Jan 18, 2016 (not updated in 10 years: call before relying on the address or phone)
- Fax
- (509) 522-1592
- Medicaid ID
- 03465758 NY
- Medicare enrollment
- Enrolled (PECOS I20131119001214); accepts Medicare assignment
- Entity
- Type 1 · individual
8 nearest medical physician assistant records → All 1,068 in Washington → Look up another NPI →
Also registered at 55 W Tietan St
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Kevin Andrews, MDInternal Medicine Physician1174513873
- Shirley Ashley, MDPediatrics Physician1922083195
- Eric Ball, M.D.Internal Medicine Physician1275507485
- Thomas Ballard, MDDiagnostic Radiology Physician1750360012
- Theodore Bergstrom, M.D.Pediatrics Physician1598739716
- Barbara Blankenship, M.D.Diagnostic Radiology Physician1356305262
Verify Stacey Renee Haveman in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Washington board licenses this profession
Search for license PA60389054Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Privia Medical Group Washington PLLCWalla Walla, WA
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Stacey Renee Haveman among 1,068 medical physician assistant records in Washington
Stacey Renee Haveman, PHYSICIAN ASSISTANT is one of 1,068 medical physician assistant records with a practice address in Washington. 66% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2011, is newer than 58% of them.
- NPI issued2011 · 58% of these records are older, 39% newer
- In a Medicare fileYes · 66% of these records are
- In the CMS Doctors and Clinicians fileYes · 54% of these records are
- Graduated2010 · median 2013 among the 581 with a school on file
- Record last updated2016 · 61% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 363AM0700X and a Washington practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
Medical Physician Assistant providers in Washington
There are 1,068 medical physician assistant records in Washington.
All 1,068 in Washington → Every provider in Walla Walla → Medical Physician Assistant nationwide →
The 8 medical physician assistant records with the nearest ZIP codes
- Jon Claridge, PA-CWalla Walla, WA 993621801447396
- Carol Flaugher-Rupe, PA-CWalla Walla, WA 993621326078163
- Hugo Reyes, PA-CWalla Walla, WA 993621811206717
- Daniel Delp, PA-CTouchet, WA 993601689705451
- John Clark, PACRoyal City, WA 993571811922982
- Robert Gates, PA-CRichland, WA 993541043291438
- Travis Henderson, PA-CRichland, WA 993541700222437
- Patricia Hernandez, PARichland, WA 993541093802373
Common questions
What is Stacey Renee Haveman, PHYSICIAN ASSISTANT's NPI number?
Stacey Renee Haveman, PHYSICIAN ASSISTANT's National Provider Identifier (NPI) is 1023309796, issued on Apr 28, 2011. An NPI identifies a provider in billing; it is not a license.
Where is Stacey Renee Haveman, PHYSICIAN ASSISTANT located?
The NPPES record lists a practice address at 55 W Tietan St, Walla Walla, WA, 99362. Phone: (509) 525-3720. Providers update this record themselves, so call before visiting.
How can I verify Stacey Renee Haveman, PHYSICIAN ASSISTANT's license?
NPPES lists Washington license number PA60389054, as entered by the provider. Search the Washington board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.