Provider Demographics
NPI:1720063902
Name:FECHNER, PATRICIA YVONNE (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:YVONNE
Last Name:FECHNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SAND POIN WAY NE
Mailing Address - Street 2:M/S A5902
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-0371
Mailing Address - Country:US
Mailing Address - Phone:206-987-5037
Mailing Address - Fax:206-987-2720
Practice Address - Street 1:4800 SAND POIN WAY NE
Practice Address - Street 2:M/S A5902
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-0371
Practice Address - Country:US
Practice Address - Phone:206-987-5037
Practice Address - Fax:206-987-2720
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG630452080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G630450Medicaid
CAF59966Medicare UPIN