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NPI Code Detail

MEDICARE: HALEY ANNE HOLLAND

MEDICARE: HALEY ANNE HOLLAND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1083555718
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALEY ANNE HOLLAND
Provider Business Mailing Address
First Line : 337 7TH AVE S
Second Line :
City : KIRKLAND
State : WA
Zip : 98033-6681
Country : US
Telephone Number : 206-819-4113
Fax Number :
Provider Business Practice Location Address
First Line : 3181 SW SAM JACKSON PARK RD
Second Line :
City : PORTLAND
State : OR
Zip : 97239-3098
Country : US
Telephone Number : 503-494-8211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ HALEY ANNE HOLLAND ” Practice Location

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