Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jonathan Roberts Haller, DSC, PA-C

Individual provider Medical Physician Assistant · NPI 1164720686

Jonathan Roberts Haller, DSC, PA-C is a Medical Physician Assistant in Fort Bragg, North Carolina. Works from 2 locations. Licensed in Washington.

Licensed in
WA
In the registry since
2011
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2817 Rock Merritt Ave
Fort Bragg, NC 28310-0001
Phone: (910) 907-8922
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 9040 Jackson Ave, Tacoma, WA 98431-0001 — (253) 968-3885

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 61085816 (WA)
Medical Physician Assistant Taxonomy 363AM0700X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1164720686
Entity typeIndividual (Type 1)
GenderMale
Credentials DSC , PA-C
Sole proprietorNo
NPI enumeratedMarch 8, 2011
Last updated in NPPESNovember 4, 2025
Certification dateNovember 4, 2025

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