Basic Information
| Provider Information | |||||||||
| NPI: | 1962966085 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FANCHER | ||||||||
| FirstName: | TAYLOR | ||||||||
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| Credential: | APRN, PMHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 N HOWARD ST STE R | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992010508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9365529909 | ||||||||
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| Practice Location | |||||||||
| Address1: | 21907 64TH AVE W STE 200 | ||||||||
| Address2: | |||||||||
| City: | MOUNTLAKE TERRACE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980436200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256407009 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2019 | ||||||||
| LastUpdateDate: | 07/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | AP61143112 | WA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.