Provider Demographics
NPI:1609965680
Name:HALLEY, ELLEN E (CRNA)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:E
Last Name:HALLEY
Suffix:
Gender:F
Credentials:CRNA
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Other - First Name:
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Mailing Address - Street 1:122 N RAYMOND RD
Mailing Address - Street 2:SUITE 20
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-6832
Mailing Address - Country:US
Mailing Address - Phone:509-926-1770
Mailing Address - Fax:509-228-9542
Practice Address - Street 1:1414 N HOUK RD
Practice Address - Street 2:SUITE 204
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1097
Practice Address - Country:US
Practice Address - Phone:509-922-0362
Practice Address - Fax:509-228-9542
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2023-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAAP30006232367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered