Provider Demographics
NPI:1881049922
Name:LAFLEUR, HALEY FAYE (PT, DPT)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:FAYE
Last Name:LAFLEUR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:FAYE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:5212 SE 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-5629
Mailing Address - Country:US
Mailing Address - Phone:503-777-1983
Mailing Address - Fax:503-771-1984
Practice Address - Street 1:5212 SE 52ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-5629
Practice Address - Country:US
Practice Address - Phone:503-777-1983
Practice Address - Fax:503-771-1984
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62370225100000X, 2251S0007X
CA291238225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist