Provider Demographics
NPI:1134466337
Name:HALEY, TAMI (MSW)
Entity Type:Individual
Prefix:MS
First Name:TAMI
Middle Name:
Last Name:HALEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8441
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-0441
Mailing Address - Country:US
Mailing Address - Phone:509-710-6292
Mailing Address - Fax:509-747-1802
Practice Address - Street 1:707 W 7TH AVE STE 294
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2833
Practice Address - Country:US
Practice Address - Phone:509-710-6292
Practice Address - Fax:509-747-1802
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 601169161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2078662Medicaid