Individual
NICOLE FANG PO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1600 116TH AVE NE STE 204, BELLEVUE, WA 98004-3056
(206) 395-4422
(888) 688-4167
Mailing address
1600 116TH AVE NE STE 204, BELLEVUE, WA 98004-3056
(206) 395-4422
(888) 688-4167
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61592676
WA
Other
Enumeration date
10/16/2024
Last updated
10/16/2024
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