Individual
GLORIA M FANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 7TH AVE STE 110, SEATTLE, WA 98101-2288
(206) 267-4390
(206) 267-4391
Mailing address
130 SUTTER ST FL 2, SAN FRANCISCO, CA 94104-4009
(415) 658-6791
(415) 520-0904
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00045842
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8467078
—
WA
Enumeration date
02/07/2007
Last updated
12/04/2018
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