Individual
DR. JAMES ALFRED FASCIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3901 HOYT AVE, EVERETT, WA 98201-4918
(425) 339-5456
(425) 303-3091
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 304-1100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
12953
NV
207Q00000X
Family Medicine Physician
G84986
CA
207Q00000X
Family Medicine Physician
Primary
MD60697846
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004716904
—
NV
05
—
00G849860
—
CA
01
—
12953
NEVADA STATE LICENSE
NV
05
—
2069525
—
WA
01
—
G84986
CA STATE LICENSE
CA
Enumeration date
02/22/2006
Last updated
06/10/2020
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