Samantha Gridley Haley, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD61058782 Issued in WA

Practice address

17000 140TH Ave NE Unit 102
Woodinville, WA 98072-6943

Phone

(425) 483-5437

Fax

(425) 488-4919

NPI assigned

Mar 28, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Samantha Jeane Gridley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Woodinville Pediatrics PLLC

  • Pediatrics Physician
  • Woodinville, WA
  • NPI 1801971254
  NPD (past)

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1801328117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 140TH AVE NE UNIT 102",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980726943",
            "telephone_number": "425-483-5437",
            "fax_number": "425-488-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 140TH AVE NE UNIT 102",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980726943",
            "telephone_number": "425-483-5437",
            "fax_number": "425-488-4919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "SAMANTHA",
        "middle_name": "GRIDLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-28",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61058782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "GRIDLEY",
            "middle_name": "JEANE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Theresa Guay, LMFT
• Myron Gudmundson, D.C.
• Deepali Gupta
• Haggen, Inc (Haggen Food & Pharmacy, TOP Food & Drug)
• Andrew John Hale, LMHCA
• Jeanne Hall-Steedman
• Lori Hall, PHARMACIST
• Sara Lynn Hamill, DC
• Hana Mind Health
• Jo Tamayao Hanson, MSW

• Pediatrics Physician in Woodinville, WA
• Providers in Woodinville, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.