Provider Demographics
NPI:1285949487
Name:HALEY, THERESA L (PT, DPT, CMP)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:L
Last Name:HALEY
Suffix:
Gender:F
Credentials:PT, DPT, CMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37624 SE FURY ST STE C201
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-9680
Mailing Address - Country:US
Mailing Address - Phone:425-292-0223
Mailing Address - Fax:425-292-9225
Practice Address - Street 1:37624 SE FURY ST STE C201
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-9680
Practice Address - Country:US
Practice Address - Phone:425-292-0223
Practice Address - Fax:425-292-9225
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60163417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist