Provider Demographics
NPI:1871017277
Name:MCFAUL, COLLEEN MARGARET (MD)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:MARGARET
Last Name:MCFAUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:MARGARET
Other - Last Name:DALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1959 NE PACIFIC ST BOX 356540
Mailing Address - Street 2:SS312
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195
Mailing Address - Country:US
Mailing Address - Phone:206-598-1994
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:UNIVERSITY OF WASHINGTON
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195
Practice Address - Country:US
Practice Address - Phone:206-598-1994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2018-03-13
Deactivation Date:2018-03-01
Deactivation Code:
Reactivation Date:2018-03-13
Provider Licenses
StateLicense IDTaxonomies
WAMD60776944207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology