Healthcare Provider Details

I. General information

NPI: 1710407853
Provider Name (Legal Business Name): HALEY NADENE SCELLICK ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 01/26/2025
Certification Date: 01/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 W WELLESLEY AVE STE 103
SPOKANE WA
99205-5011
US

IV. Provider business mailing address

2225 W WELLESLEY AVE STE 103
SPOKANE WA
99205-5011
US

V. Phone/Fax

Practice location:
  • Phone: 509-266-3701
  • Fax: 866-510-7929
Mailing address:
  • Phone: 509-266-3701
  • Fax: 866-510-7929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberAP60757019
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60757019
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: