Individual
DR. LILIA A FANNIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 S 320TH ST, FEDERAL WAY, WA 98003-5200
(253) 874-7958
Mailing address
301 S 320TH ST, FEDERAL WAY, WA 98003-5200
(253) 874-7000
(425) 874-7557
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00038350
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8881433
MEDICARE
WA
01
—
G8881434
MEDICARE
WA
Enumeration date
04/18/2006
Last updated
04/05/2021
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