Individual
HALEY K VAN ENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
9414 RIDGETOP BLVD NW, SILVERDALE, WA 98383-8525
(360) 286-2647
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60335722
WA
225X00000X
Occupational Therapist
TL60335186
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029332
—
WA
01
—
313602
LABOR & INDUSTRIES
WA
01
—
P01257956
RR MEDICARE
WA
Enumeration date
03/04/2013
Last updated
11/19/2020
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