Provider Demographics
NPI:1275628513
Name:FOX-BARROW, MARNE LAYNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MARNE
Middle Name:LAYNE
Last Name:FOX-BARROW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-899-5200
Mailing Address - Fax:425-899-5204
Practice Address - Street 1:11800 NE 128TH ST
Practice Address - Street 2:STE 560
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034
Practice Address - Country:US
Practice Address - Phone:425-899-5200
Practice Address - Fax:425-899-5204
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2075823Medicaid