Provider Demographics
NPI:1073132916
Name:O'HORA, HALEY CHRISTINE (PA-C)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:CHRISTINE
Last Name:O'HORA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15214 CANYON RD E STE 120
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-7457
Mailing Address - Country:US
Mailing Address - Phone:253-539-6078
Mailing Address - Fax:253-539-6045
Practice Address - Street 1:15214 CANYON RD E STE 120
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-7457
Practice Address - Country:US
Practice Address - Phone:253-539-6078
Practice Address - Fax:253-539-6045
Is Sole Proprietor?:No
Enumeration Date:2020-04-10
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61521364363AM0700X
MI5601010204363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2295656Medicaid