Provider Demographics
NPI:1871552067
Name:CANBY, RAYLENE FELLOWS (PA-C)
Entity type:Individual
Prefix:MS
First Name:RAYLENE
Middle Name:FELLOWS
Last Name:CANBY
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:112/OTO
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1532
Mailing Address - Country:US
Mailing Address - Phone:206-764-2359
Mailing Address - Fax:206-764-2672
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:112/OTO
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-764-2359
Practice Address - Fax:206-764-2672
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2007-09-13
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Provider Licenses
StateLicense IDTaxonomies
WA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant