Provider Demographics
NPI:1740721034
Name:HALAMA, PAULA KAY (FNP-C)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:KAY
Last Name:HALAMA
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:PAULA
Other - Middle Name:KAY
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-3550
Mailing Address - Country:US
Mailing Address - Phone:509-853-1082
Mailing Address - Fax:509-452-5224
Practice Address - Street 1:521 E MOUNTAIN VIEW AVE
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3865
Practice Address - Country:US
Practice Address - Phone:509-962-1414
Practice Address - Fax:509-452-5224
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT124910363LF0000X
WAAP61669370363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2115202Medicaid