Provider Demographics
NPI:1740756360
Name:HAIRE, NATALIA V (CNM/ARNP)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:V
Last Name:HAIRE
Suffix:
Gender:F
Credentials:CNM/ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 DIVISION AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-1646
Mailing Address - Country:US
Mailing Address - Phone:253-403-9860
Mailing Address - Fax:
Practice Address - Street 1:1105 DIVISION AVE STE 101
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-1646
Practice Address - Country:US
Practice Address - Phone:253-403-9860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAP60903573363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology