Provider Demographics
NPI:1114561461
Name:WEBB, HALEY (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 SW 6TH ST APT 201
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2763
Mailing Address - Country:US
Mailing Address - Phone:541-699-1160
Mailing Address - Fax:
Practice Address - Street 1:535 SW 6TH ST APT 201
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-2763
Practice Address - Country:US
Practice Address - Phone:541-699-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR428821225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR428821OtherLICENSED OCCUPATIONAL THERAPIST