Provider Demographics
NPI:1043252323
Name:HAWS, JOANNA (OD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:HAWS
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5321 CORPORATE CENTER LOOP SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-5559
Mailing Address - Country:US
Mailing Address - Phone:360-459-2108
Mailing Address - Fax:360-459-2875
Practice Address - Street 1:5321 CORPORATE CENTER LOOP SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5559
Practice Address - Country:US
Practice Address - Phone:360-459-2108
Practice Address - Fax:360-459-2875
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003901152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2030591Medicaid
WAG8866595Medicare PIN
V05163Medicare UPIN
WA0551250001Medicare NSC