Healthcare Provider Details

I. General information

NPI: 1851228795
Provider Name (Legal Business Name): FATIMA FAREED PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 GAGE BLVD STE 101
RICHLAND WA
99352-9531
US

IV. Provider business mailing address

560 GAGE BLVD STE 101&206
RICHLAND WA
99352-8650
US

V. Phone/Fax

Practice location:
  • Phone: 590-942-3286
  • Fax: 509-628-1354
Mailing address:
  • Phone: 509-942-3286
  • Fax: 509-628-1354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA70047471
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: