MEDICARE: WHITNEY BLAIRE FANCHER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	125059648	IL
2	207N00000X	Dermatology Physician	MD60644753	WA
3	207N00000X	Dermatology Physician	MD177022	OR
4	207N00000X	Dermatology Physician	63662	WI
5	207ND0101X	MOHS-Micrographic Surgery Physician	MD60644753	WA
6	207ND0101X	MOHS-Micrographic Surgery Physician	63662	WI
7	207ND0101X	MOHS-Micrographic Surgery Physician	MD177022	OR

General Provider Information

NPI Number	:	1053699645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WHITNEY BLAIRE FANCHER M.D.

Provider Business Mailing Address
First Line	:	1793 13TH ST SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-2541
Country	:	US
Telephone Number	:	503-362-8385
Fax Number	:	503-362-8435

Provider Business Practice Location Address
First Line	:	1106 DOUGLAS ST STE F
Second Line	:
City	:	LONGVIEW
State	:	WA
Zip	:	98632-2429
Country	:	US
Telephone Number	:	360-636-4500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2011
Last Update Date	:	02/10/2021

Similar Medicare Providers

1225051097 — JOHN E RICHARDS M.D.
Practice Location Address:

1106 DOUGLAS ST , STE D
LONGVIEW, WA
98632-2429

Practice Phone: 360-423-9229
Practice Fax: 360-423-9230

1881894152 — DR. LYNELLE NANCY NOISY HAWK MD
Practice Location Address:

PO BOX 2429
LONGVIEW, WA
98632-8486

Practice Phone: 360-353-9494
Practice Fax:

1235417007 — SHERYL DIANE SPAHR LMHC
Practice Location Address:

PO BOX 2429
LONGVIEW, WA
98632-8486

Practice Phone: 360-353-9422
Practice Fax: 360-575-1950

1124858550 — KATHERINE EDINGTON REGISTERED NURSE
Practice Location Address:

PO BOX 2429
LONGVIEW, WA
98632-8486

Practice Phone: 360-577-8140
Practice Fax:

1881564821 — AUDREY JEAN HORSEY
Practice Location Address:

PO BOX 2429
LONGVIEW, WA
98632-8486

Practice Phone: 360-353-9422
Practice Fax: 360-575-1950

1538794227 — JAZZLYN LAWSON
Practice Location Address:

507 E PIRATE ST
LONGVIEW, TX
75604-2429

Practice Phone: 903-736-7848
Practice Fax:

Directions to “ WHITNEY BLAIRE FANCHER M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.