Healthcare Provider Details

I. General information

NPI: 1639908205
Provider Name (Legal Business Name): HAYLEY MITCHELL NEUBERT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HAYLEY REBECCA NEUBERT RN

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 E YESLER WAY
SEATTLE WA
98122-5959
US

IV. Provider business mailing address

3930 SW IDA ST
SEATTLE WA
98136-2152
US

V. Phone/Fax

Practice location:
  • Phone: 206-299-1900
  • Fax:
Mailing address:
  • Phone: 828-337-0781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number60278243
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: