Healthcare Provider Details

I. General information

NPI: 1306561816
Provider Name (Legal Business Name): HAELEY DEASON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9179 W THUNDERBIRD RD STE 101
PEORIA AZ
85381-4912
US

IV. Provider business mailing address

655 S DOBSON RD STE 101
CHANDLER AZ
85224-5668
US

V. Phone/Fax

Practice location:
  • Phone: 602-374-3440
  • Fax:
Mailing address:
  • Phone: 480-459-2555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9385
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: