Basic Information
| Provider Information | |||||||||
| NPI: | 1760031728 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FARANCE | ||||||||
| FirstName: | AMBER | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2620 13TH ST | ||||||||
| Address2: | |||||||||
| City: | CLARKSTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 994033206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092547050 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11120 NE 33RD PL STE 202 | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980041444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068231004 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2019 | ||||||||
| LastUpdateDate: | 05/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA61117581 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.