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Individual

MACON FULIAR HENRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
2901 SQUALICUM PKWY, BELLINGHAM, WA 98225-1851
(360) 788-6841
Mailing address
2490 PINE DR, FERNDALE, WA 98248-9273
(415) 726-8971

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
705159
TX
363LA2100X
Acute Care Nurse Practitioner
95014151
CA
363LA2100X
Acute Care Nurse Practitioner
AP144838
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP61088966
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2172703
WA
Enumeration date
04/10/2007
Last updated
02/14/2022
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