Provider Demographics
NPI:1558049148
Name:BUTLER, HALLIE (ARNP)
Entity Type:Individual
Prefix:
First Name:HALLIE
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E CENTRAL AVE STE 360
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4502
Mailing Address - Country:US
Mailing Address - Phone:509-553-0565
Mailing Address - Fax:
Practice Address - Street 1:212 E CENTRAL AVE STE 360
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-4502
Practice Address - Country:US
Practice Address - Phone:509-553-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61463802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily