Individual
DANIELLE BULLARD FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
907 GEORGIANA ST, PORT ANGELES, WA 98362-3911
(360) 565-0999
(360) 457-1599
Mailing address
PO BOX 850, PORT ANGELES, WA 98362-0146
(360) 565-9237
(360) 457-1599
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
504
WY
363A00000X
Physician Assistant
7969893-1206
UT
363A00000X
Physician Assistant
PA0003481
CO
363A00000X
Physician Assistant
PA22090
CA
363A00000X
Physician Assistant
Primary
PA60143632
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0223082
LABOR & INDUSTRIES
WA
05
—
1016622
—
WA
Enumeration date
07/13/2005
Last updated
07/21/2022
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