Provider Demographics
NPI:1255118097
Name:HAVEMAN, HANNAH LOTTE
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:LOTTE
Last Name:HAVEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18333 BOTHELL WAY NE APT 327
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-1913
Mailing Address - Country:US
Mailing Address - Phone:720-234-1909
Mailing Address - Fax:
Practice Address - Street 1:18333 BOTHELL WAY NE APT 327
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-1913
Practice Address - Country:US
Practice Address - Phone:720-234-1909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program