Healthcare Provider Details

I. General information

NPI: 1528708120
Provider Name (Legal Business Name): HALEY MARIE EGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15833 MILL CREEK BLVD # 12010
MILL CREEK WA
98012-1200
US

IV. Provider business mailing address

15833 MILL CREEK BLVD # 12010
MILL CREEK WA
98012-1200
US

V. Phone/Fax

Practice location:
  • Phone: 425-259-0212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD.MD.61568488
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: