Individual
FALLON ANN CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
939 CAROLINE ST, PORT ANGELES, WA 98362-3997
(360) 565-0999
(360) 565-9251
Mailing address
907 GEORGIANA ST, PORT ANGELES, WA 98362-3911
(360) 565-0999
(360) 565-9251
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60922624
WA
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
12/26/2018
Last updated
11/04/2020
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