Whitney Blaire Fancher
Dermatologist MOHS-Micrographic Surgeon and 3 more
1106 Douglas St Ste F
Longview
, Washington 98632-2429
Whitney Blaire Fancher
Dermatologist MOHS-Micrographic Surgeon and 3 more
1106 Douglas St Ste F
Longview
, Washington 98632-2429
(503) 362-8435
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About
Features
Specialties
- Dermatologist
- MOHS-Micrographic Surgeon
Languages spoken
- English
Location
First Address
- Whitney Blaire Fancher
- 1793 13th St Se
- Salem, OR
- Zip : 97302-2541
- Fax : (503) 362-8435
- Phone : (503) 362-8385
Second Address
- Whitney Blaire Fancher
- 1106 Douglas St Ste F
- Longview, WA
- Zip : 98632-2429
- Phone : (360) 636-4500
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Is Whitney Blaire Fancher a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207N00000X | Dermatologist | 125059648 | IL |
| N | 207N00000X | Dermatologist | 63662 | WI |
| N | 207N00000X | Dermatologist | MD177022 | OR |
| N | 207N00000X | Dermatologist | MD60644753 | WA |
| N | 207ND0101X | MOHS-Micrographic Surgeon | 63662 | WI |
| Y | 207ND0101X | MOHS-Micrographic Surgeon | MD177022 | OR |
| N | 207ND0101X | MOHS-Micrographic Surgeon | MD60644753 | WA |
National Provider Identifier
| NPI | 1053699645 |
|---|---|
| Provider Name | Whitney Blaire Fancher |
| First Address | Salem, OR 97302-2541 |
| Second Address | Longview, WA 98632-2429 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/07/2011 |
| Last Update Date | 10/02/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.