Provider Demographics
NPI:1336113885
Name:MCFARLANE, DIANA J (PA-C)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:J
Last Name:MCFARLANE
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 1:1100 9TH AVE
Mailing Address - Street 2:MS M4-PA
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2756
Mailing Address - Country:US
Mailing Address - Phone:206-515-5881
Mailing Address - Fax:206-515-5886
Practice Address - Street 1:1100 9TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2756
Practice Address - Country:US
Practice Address - Phone:206-223-2319
Practice Address - Fax:206-341-1330
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004893363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7841604Medicaid
MT1336113885Medicaid
WA3361MCOtherBLUE SHIELD # VM
WA8439747Medicaid
WAP00444071OtherRAILROAD MC # VM
WA8904630Medicare PIN
WA8868417Medicare PIN
WAQ56401Medicare UPIN
WA8439747Medicaid
WA8817159Medicare PIN