Provider Demographics
NPI:1881884385
Name:PAN, FEI (MD)
Entity type:Individual
Prefix:DR
First Name:FEI
Middle Name:
Last Name:PAN
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 1:3900 S ZINTEL WAY
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-5092
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-942-2268
Practice Address - Street 1:1100 GOETHALS DRIVE
Practice Address - Street 2:KADLEC NEUROSCIENCE CENTER
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3304
Practice Address - Country:US
Practice Address - Phone:509-946-7931
Practice Address - Fax:509-946-7223
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD602804572084N0400X
MO2007016058390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program