Haley Elise Gravely, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61396582 Issued in WA

Practice address

19917 7TH Ave NE Ste 101
Poulsbo, WA 98370-6555

Phone

(360) 824-5474

Fax

(360) 994-4975

NPI assigned

Jun 30, 2022

Last updated

Sep 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Silver Falls Dermatology LLCGroup PAC ID 5890863492, 100 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
• Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323

Merit-based Incentive Payment System (MIPS)

Final score

90.65 of 100Reported as group

Promoting interoperability

89

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Silver Falls Dermatology, LLC

  dba Frontier Dermatology

  • Dermatology Physician
  • Salem, OR
  • NPI 1134375421

  Physician Assistant, WA

  Medicare reassignment Care Compare group NPD
• Gray Derm PLLC

  dba Gray Derm LLC

  • Dermatology Physician
  • Lima, OH
  • NPI 1104392679
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clallam County Public Hospital District 2

  dba Olympic Medical Center

  • General Acute Care Hospital
  • Port Angeles, WA
  • NPI 1306845557
  Care Compare affiliation
• Jefferson County Public Hospital District No 2

  dba Jefferson Healthcare Swingbed

  • Medicare Defined Swing Bed Hospital Unit
  • Port Townsend, WA
  • NPI 1104950039
  Care Compare affiliation
• Jefferson County Public Hospital District No 2

  dba Jefferson Healthcare

  • Critical Access Hospital
  • Port Townsend, WA
  • NPI 1356492953
  Care Compare affiliation
• Jefferson County Public Hospital District No 2

  dba Sleep Medicine, Jefferson Healthcare

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Silverdale, WA
  • NPI 1467664631

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1043942766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1793 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022541",
            "telephone_number": "503-362-8385",
            "fax_number": "503-362-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19917 7TH AVE NE STE 101",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706555",
            "telephone_number": "360-824-5474",
            "fax_number": "360-994-4975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "565 Eureka Way",
            "address_purpose": "LOCATION",
            "city": "Sequim",
            "state": "WA",
            "postal_code": "983825074",
            "country_code": "US",
            "telephone_number": "360-749-8064",
            "fax_number": "360-994-4975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVELY",
        "first_name": "HALEY",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-30",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007657RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61396582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Cho Gip, D.C.
• John B. Goessman, DDS
• Alaina Marie Gordon, OTR
• Raymond Graber, LMT
• Grant Edward Taylor (Grant Taylor DC)
• Milana Gray
• Melanie Green, N.D.
• Megan Greenlaw, MA
• Grey Jedi Alliance LLC (Home Helpers & Direct Link)
• Bridget Grim, LMP

• Physician Assistant in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.