Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Haley Brooke Moak, PA-C

Individual provider Physician Assistant · NPI 1639697709

Haley Brooke Moak, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2017, 9 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
9
Licensed in
OR
In the registry since
2017
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10803 SE Cherry Blossom Dr
Portland, OR 97216-3107
Phone: (503) 261-7200
Fax: (503) 261-7226
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (OR)

Record details

NPI number1639697709
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedSeptember 8, 2017
Last updated in NPPESSeptember 8, 2017
Mailing address911 Sw 21st Ave Apt 204, Portland, OR 97205-1565

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

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