Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | D9212 | OR |
NPI | 1053566604 |
---|---|
Provider Name | Dr. Aaron Daniel Haskett |
First Address | West Linn, OR 97068-1718 |
Second Address | West Linn, OR 97068-1718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2008 |
Last Update Date | 30/11/2009 |