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General NPI Number Information
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NPI Number | 1518573377
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Entity Type | Individual
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Provider Name | FAYTH TAYLOR HEBERT PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 222 NE PARK PLAZA DR STE 100
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City | VANCOUVER
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State | WA
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Zip | 98684-5895
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Country | US
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Telephone | 360-254-8025
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Fax | 360-254-8618
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Provider Business Mailing Address
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Address Line | PO BOX 1517
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City | PENDLETON
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State | OR
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Zip | 97801-0410
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Country | US
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Telephone | 877-708-1119
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Fax | 541-278-8349
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5197-23
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License Number State | WI
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