Individual ProviderDaniel W HauptPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansPractice Address3181 SW Sam Jackson Park Rd, Psychiatry Uhn 80, Portland, OR 97239-3011(503) 494-8144PECOS EnrollmentBased on the most recent information from CMS, provider Daniel W Haupt does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1497772925Provider TypeIndividualFull NameHaupt, Daniel WTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date7/17/2006Last Updated10/11/2012Contact InformationPractice LocationPractice Address3181 SW Sam Jackson Park Rd, Psychiatry Uhn 80, Portland, OR 97239-3011Phone(503) 494-8144Fax(503) 494-6152Mailing LocationMailing Address3181 SW Sam Jackson Park Rd, Psychiatry Uhn 80, Portland, OR 97239-3011Phone(503) 494-8144Fax(503) 494-6152Provider TaxonomiesCodeDescriptionLicenseCode2084P0800XPrimaryDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicenseMD157566OregonCode2084P0800XDescriptionPsychiatry & NeurologyAllopathic & Osteopathic PhysiciansLicense113283MissouriProvider IdentifiersIDDescriptionIssuerID204698914DescriptionMedicaidIssuerUnlistedMissouri