Provider Demographics
NPI:1194918334
Name:JEFFREY P. HAGGQUIST, DO, PLLC
Entity type:Organization
Organization Name:JEFFREY P. HAGGQUIST, DO, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:P
Authorized Official - Last Name:HAGGQUIST
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:202-244-8222
Mailing Address - Street 1:5630 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2600
Mailing Address - Country:US
Mailing Address - Phone:202-244-8222
Mailing Address - Fax:202-244-7432
Practice Address - Street 1:5630 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 2
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2600
Practice Address - Country:US
Practice Address - Phone:202-244-8222
Practice Address - Fax:202-244-7432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation