# FAN PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891490645
- **Authorized official:** ANTHONY FAN MD (OWNER)
- **Authorized official phone:** (206) 412-2702

## Contact information

- **Practice address:** 6165 90TH AVE SE, MERCER ISLAND, WA 98040-4516
- **Practice address phone:** (206) 412-2702
- **Mailing address:** 6165 90TH AVE SE, MERCER ISLAND, WA 98040-4516

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/03/2023
- **Last updated:** 07/16/2026