Healthcare Provider Details

I. General information

NPI: 1275161101
Provider Name (Legal Business Name): HAYLEY COWAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST RM B316
SEATTLE WA
98195-6365
US

IV. Provider business mailing address

1959 NE PACIFIC ST RM B307
SEATTLE WA
98195-6365
US

V. Phone/Fax

Practice location:
  • Phone: 206-543-5006
  • Fax:
Mailing address:
  • Phone: 206-543-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0008X
TaxonomyOral and Maxillofacial Radiology Dentistry
License NumberDE61049435
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE61049435
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: