Healthcare Provider Details

I. General information

NPI: 1659054823
Provider Name (Legal Business Name): HALEY RAE HUTCHINSON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

432 3RD ST
LANGLEY WA
98260-9627
US

IV. Provider business mailing address

432 3RD ST
LANGLEY WA
98260-9627
US

V. Phone/Fax

Practice location:
  • Phone: 360-321-4434
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number61465759
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: