Individual
MRS. HALEY ELISE GRAVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19917 7TH AVE NE STE 101, POULSBO, WA 98370-6555
(360) 824-5474
(360) 994-4975
Mailing address
1793 13TH ST SE, SALEM, OR 97302-2541
(503) 362-8385
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.007657RX
OH
363A00000X
Physician Assistant
Primary
PA61396582
WA
Other
Enumeration date
06/30/2022
Last updated
09/27/2024
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