DR. MICHAEL ELLERY FARAN (NPI# 1760451082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760451082 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL ELLERY FARAN |
| Credential | MD |
| Practice Address |
9040 Jackson Ave Madigan Army Medical Center Tacoma WA 98431-0001 |
| Practice Telephone | 2539680758 |
| Mailing Telephone | 2539680758 |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2019-04-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
7712 | HI | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
7712 | HI | Allopathic & Osteopathic Physicians |
| Street Address |
9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386641694 | Muhammad Ayub | Family Medicine | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2005-06-30 |
| 1699399659 | Haywood Maurice Mcrae | Social Worker | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2020-06-04 |
| 1710490677 | Layne Jensen | Registered Nurse | 9040 Jackson Ave Madigan Army Medical Center, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-11-14 |
| 1437679636 | Michael John Zylstra | General Practice | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-5001 | 2017-06-20 |
| 1033666581 | Diana Monzon | Registered Nurse | 9040 Jackson Ave Madigan Army Medical Center, Attn: Mchj-clq-c, Tacoma, WA 98413-1100 | 2016-09-01 |
| 1639541717 | Justin Schafer | Physician Assistant | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2015-10-28 |
| 1164768008 | Kelly Avant | Physical Therapist | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2012-12-21 |
| 1013270180 | Nichole Lynn Mogharreban | Psychologist | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2012-06-22 |
| 1891058145 | Kristopher M Peters | Dermatology | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-4613 | 2012-06-21 |
| 1992066765 | Matthew Steven Reece | Anesthesiology | 9040 Jackson Ave Madigan Army Medical Center, Tacoma, WA 98431-5001 | 2012-06-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043624240 | Lucas Mcintyre | Psychiatry & Neurology | 316 S I St Fl 1, Tacoma, WA 98405-4212 | 2014-06-16 |
| 1679659965 | Stephen Neal Schilt | Psychiatry & Neurology | 7609 6th Ave, Tacoma, WA 98406-1060 | 2006-10-28 |
| 1689647141 | Lindsay B Paden | Psychiatry & Neurology | Department of Psychiatry, Code Mchj-ps, Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2006-02-07 |
| 1093857724 | Sean M Killoran | Psychiatry & Neurology | 4301 S Pine St, Ste 301, Tacoma, WA 98409-7264 | 2007-02-12 |
| 1518017946 | David R Camenisch | Psychiatry & Neurology | 5410 N 44th St, Tacoma, WA 98407-3715 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225674963 | Multicare Health System | Psychiatry & Neurology | 4700 Point Fosdick Dr Ste 319, Gig Harbor, WA 98335-1731 | 2019-11-18 |
| 1235792326 | Wellpsyche Seattle PC | Psychiatry & Neurology | 801 2nd Ave Ste 800, Seattle, WA 98104-1573 | 2019-04-15 |
| 1184043010 | Shad Syed Ali | Psychiatry & Neurology | 2511 M Ave Ste G, Anacortes, WA 98221-3897 | 2014-04-08 |
| 1710223896 | Jack Raskin | Psychiatry & Neurology | 2624 161st Ave Se, Bellevue, WA 98008-5424 | 2012-12-18 |
| 1801140876 | Deborah L. Hickey, D.o.ps | Psychiatry & Neurology | 6512-20th St Ct W #c, Firerest, WA 98466-6212 | 2012-10-30 |
| 1073884102 | Larry W. Einspahr, M.d., P.s. | Psychiatry & Neurology | 5400 Carillon Pt Bldg 5000, 4th Floor, Kirkland, WA 98033-7357 | 2012-01-20 |
| 1982922233 | Brian N Gipstein | Psychiatry & Neurology | 4407 S Madelia St, Spokane, WA 99223-6429 | 2010-05-12 |
| 1063667087 | Robert S Fleming II | Psychiatry & Neurology | 16921 14th Ave Nw, Shoreline, WA 98177-3840 | 2008-11-18 |
| 1306000898 | Amy Lazar | Psychiatry & Neurology | 11820 Northup Way Ste E200, Bellevue, WA 98005-1966 | 2008-07-14 |
| 1427278100 | Melanie Jeanne Brace | Psychiatry & Neurology | 3206 50th Street Ct Nw Ste A101, Gig Harbor, WA 98335-8568 | 2007-04-26 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.