Provider Demographics
NPI:1962279612
Name:BOOKMAN, HAVILAH R (CBD)
Entity type:Individual
Prefix:
First Name:HAVILAH
Middle Name:R
Last Name:BOOKMAN
Suffix:
Gender:F
Credentials:CBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17638 218TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-7110
Mailing Address - Country:US
Mailing Address - Phone:719-744-3585
Mailing Address - Fax:
Practice Address - Street 1:17638 218TH AVE NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98077-7110
Practice Address - Country:US
Practice Address - Phone:719-744-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty