Provider Demographics
NPI:1841967775
Name:PURYEAR, HALEY ANNE (CNIM)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:ANNE
Last Name:PURYEAR
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:MS
Other - First Name:HALEY
Other - Middle Name:ANNE
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 760
Mailing Address - Street 2:
Mailing Address - City:FOX ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98333-0760
Mailing Address - Country:US
Mailing Address - Phone:360-539-8487
Mailing Address - Fax:360-358-9944
Practice Address - Street 1:9333 MARTIN WAY E, SUITE 214
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-5969
Practice Address - Country:US
Practice Address - Phone:360-539-8487
Practice Address - Fax:360-358-9944
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic