Provider Demographics
NPI:1699825463
Name:MCCUAIG, FAIRLETH PATRICIA (ARNP)
Entity type:Individual
Prefix:MS
First Name:FAIRLETH
Middle Name:PATRICIA
Last Name:MCCUAIG
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 COYLTON PLACE
Mailing Address - Street 2:
Mailing Address - City:PORT MOODY
Mailing Address - State:BRITISH COLUMBIA
Mailing Address - Zip Code:V3H1A9
Mailing Address - Country:CA
Mailing Address - Phone:604-936-7572
Mailing Address - Fax:
Practice Address - Street 1:910 HARRIS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7008
Practice Address - Country:US
Practice Address - Phone:360-734-2131
Practice Address - Fax:360-527-2187
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007046363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily