Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kevan J. Haack, PA-C

Individual provider Surgical Physician Assistant · NPI 1083061501

Kevan J. Haack, PA-C is a Physician Assistant in Seattle, Washington. Qualified in 2017, 9 years ago. Practices with Opa Ortho PLLC, a 41-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
9
Licensed in
WA
In the registry since
2016
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

601 Broadway Fl 7
Seattle, WA 98122-5330
Phone: (206) 386-2600
Fax: (206) 622-1644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4455 148th Ave Ne # B1, Bellevue, WA 98007-3120 — (206) 386-2600

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA60815264 (WA)

Record details

NPI number1083061501
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 16, 2016
Last updated in NPPESJuly 26, 2024
Certification dateJuly 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Opa Ortho Pllc — 41 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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