Individual
HAYLEY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 LYNCH CREEK RD E, EATONVILLE, WA 98328
(360) 879-1600
Mailing address
PO BOX 698, EATONVILLE, WA 98328-0698
(360) 879-1000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SI61222035
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
578189C
WASHINGTON OSPI
WA
01
—
SI61222035
WASHINGTON DEPARTMENT OF HEALTH
WA
Enumeration date
11/19/2021
Last updated
11/19/2021
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