Provider Demographics
NPI:1932800372
Name:HALEY, PAIGE ADAMS
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:ADAMS
Last Name:HALEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 NW OVERTON ST APT 211
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2693
Mailing Address - Country:US
Mailing Address - Phone:503-709-6732
Mailing Address - Fax:
Practice Address - Street 1:1161 NW OVERTON ST APT 211
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2693
Practice Address - Country:US
Practice Address - Phone:503-709-6732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program