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KENNETH A HAVERLAND PA-C
NPI 1487842761
Physician Assistant - Surgical in Seattle, WA

Active since October 11, 2007PECOS Enrolled
1959 NE PACIFIC ST STE AA115, BOX # 356310, SEATTLE, WA 98195(206) 543-3093(206) 543-0325 Get Directions Write a Review

NPPES record last updated: June 14, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kenneth A Haverland Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH A HAVERLAND PA-C (NPI 1487842761) is an individual surgical provider in Seattle, Washington, licensed in Washington (PA10005309) and active in the NPI registry since October 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1487842761
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameKENNETH A HAVERLANDCredential: PA-C
Location Address1959 NE PACIFIC ST STE AA115, BOX # 356310Seattle, WA 98195-0001
Mailing Address1959 Ne Pacific St Ste Aa115, Box # 356310Seattle, WA 98195-0001 · (206) 543-3093 · Fax (206) 543-0325
Phone(206) 543-3093
Fax(206) 543-0325
Sole ProprietorNo
Enumeration DateOctober 11, 2007
Last NPPES UpdateJune 14, 2008
✔ NPI 1487842761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in WA · PA10005309
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA10005309 (WA)
1959 NE PACIFIC ST STE AA115, Seattle, WA 98195
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Other Identifiers 1

Medicare PIN8869235WA

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth A Haverland Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Haverland's NPI number?

The NPI number for Kenneth Haverland is 1487842761. It was assigned to this individual provider in the NPPES registry on October 11, 2007.

Where is Kenneth Haverland located?

Kenneth Haverland practices at 1959 NE Pacific St Ste Aa115 Box # 356310, Seattle, WA 98195. The listed phone number is (206) 543-3093.

What is Kenneth Haverland's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Kenneth Haverland enrolled in Medicare?

Yes. Kenneth Haverland is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Haverland was last updated on June 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.