Healthcare Provider Details

I. General information

NPI: 1659969988
Provider Name (Legal Business Name): HALEY LEIGHTON ARCHER NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2021
Last Update Date: 10/18/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4752 RUTHERFORD CIR SW
PORT ORCHARD WA
98367-6430
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2000
  • Fax:
Mailing address:
  • Phone: 303-506-6991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAP61194853
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN60631415
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: