Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1787 | OR |
Y | 103TC0700X | Clinical Psychologist | 1787 | OR |
NPI | 1003095209 |
---|---|
Provider Name | Dr. David Hugh Haven |
First Address | Portland, OR 97232-1410 |
Second Address | Portland, OR 97232-1410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2007 |
Last Update Date | 07/12/2012 |