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General NPI Number Information
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NPI Number | 1023973690
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Entity Type | Individual
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Provider Name | HALEY HOLBORN
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Gender | Female
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 1620 LAKE TAPPS PKWY SE STE 110
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City | AUBURN
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State | WA
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Zip | 98092-8376
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Country | US
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Telephone | 253-939-7181
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Fax | 253-939-7184
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Provider Business Mailing Address
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Address Line | 1650 LYNDON FARM CT STE 300
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City | LOUISVILLE
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State | KY
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Zip | 40223-5005
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Country | US
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Telephone | 726-202-3039
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Fax | 210-978-5592
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DI70075244
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License Number State | WA
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