Provider Demographics
NPI:1699774661
Name:FRANKLIN, EARL B (PA C)
Entity type:Individual
Prefix:
First Name:EARL
Middle Name:B
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 KING ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-6223
Mailing Address - Country:US
Mailing Address - Phone:360-676-1696
Mailing Address - Fax:360-676-6636
Practice Address - Street 1:1345 KING ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6223
Practice Address - Country:US
Practice Address - Phone:360-676-1696
Practice Address - Fax:360-676-6636
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10003182363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1699774661Medicaid
WA52055OtherREGENCE
WA5857FROtherBSWA
605960012OtherUSDLAB
WA0230089OtherL&I AND CRIME VICTIMS
WA52055OtherREGENCE
WA1699774661Medicaid