Provider Demographics
NPI:1265739684
Name:HALEY, AMY (MD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HALEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4545 CORDATA PKWY STE 1F
Mailing Address - Street 2:PEDIATRICS
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-7123
Mailing Address - Country:US
Mailing Address - Phone:360-738-2200
Mailing Address - Fax:360-752-5679
Practice Address - Street 1:4545 CORDATA PKWY STE 1F
Practice Address - Street 2:PEDIATRICS
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-7123
Practice Address - Country:US
Practice Address - Phone:360-738-2200
Practice Address - Fax:360-752-5679
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2013-10-16
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60347465208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics