MEDICARE: BRIANNA FULLER PA-C

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1881370328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA FULLER PA-C

Provider Business Mailing Address
First Line	:	8212 S MARCH POINT RD
Second Line	:
City	:	ANACORTES
State	:	WA
Zip	:	98221-8684
Country	:	US
Telephone Number	:	360-296-3668
Fax Number	:

Provider Business Practice Location Address
First Line	:	8212 S MARCH POINT RD
Second Line	:
City	:	ANACORTES
State	:	WA
Zip	:	98221-8684
Country	:	US
Telephone Number	:	360-588-2800
Fax Number	:

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

Provider Enumeration Date	:	06/27/2023
Last Update Date	:	05/05/2026

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