Provider Demographics
NPI:1295582575
Name:HAUSKAA PSYCHIATRY LLC
Entity type:Organization
Organization Name:HAUSKAA PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:KOIVISTO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:503-522-2831
Mailing Address - Street 1:7145 SW VARNS ST STE 101
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8170
Mailing Address - Country:US
Mailing Address - Phone:971-405-2584
Mailing Address - Fax:
Practice Address - Street 1:7145 SW VARNS ST STE 101
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8170
Practice Address - Country:US
Practice Address - Phone:971-405-2584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty