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Individual

EDWARD R FAHY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1530 S UNION AVE, SUITE 8, TACOMA, WA 98405-1954
(253) 759-3333
(253) 759-1415
Mailing address
8815 71ST ST NW, GIG HARBOR, WA 98335-6279
(253) 238-8041

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00030091
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
163331
LABOR AND INDUSTRIES
WA
05
8155137
WA
Enumeration date
02/21/2006
Last updated
06/21/2008
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