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General NPI Number Information
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NPI Number | 1659161800
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Entity Type | Individual
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Provider Name | HALEY ANNE SHANNON ARNP
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Gender | Female
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Dates
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Enumeration Date | 05/10/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 945 GOETHALS DR STE 200
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City | RICHLAND
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State | WA
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Zip | 99352-3552
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Country | US
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Telephone | 509-942-2555
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Fax |
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Provider Business Mailing Address
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Address Line | 6607 CHINOOK LN
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City | PASCO
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State | WA
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Zip | 99301-8563
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Country | US
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Telephone | 509-619-4276
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP61665468
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License Number State | WA
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