# MS. CAROLYN STARR FULLMER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1275686669
- **Gender:** F
- **Credential:** PAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10003285 | WA | Yes |

## Other

- **Enumeration date:** 01/19/2007
- **Last updated:** 06/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0159376 | WA STATE L&I | WA |
| 05 | — | 8511230 | — | WA |
| 01 | — | PA10003285 | WA STATE LICENSE | WA |