Provider Demographics
NPI:1487611448
Name:BYERS, CANDACE (PA-C, FNP-C)
Entity type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:
Last Name:BYERS
Suffix:
Gender:F
Credentials:PA-C, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-2443
Mailing Address - Country:US
Mailing Address - Phone:360-437-5067
Mailing Address - Fax:360-437-4158
Practice Address - Street 1:294843 US HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:QUILCENE
Practice Address - State:WA
Practice Address - Zip Code:98376-9800
Practice Address - Country:US
Practice Address - Phone:360-385-3991
Practice Address - Fax:360-765-3811
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA 60082362363AM0700X
OR202100055NP-PP363LF0000X
WAAP61157568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR202100055NP-PPOtherLICENSE TO PRACTICE
CAPA 12097OtherLICENSE TO PRACTICE
WAPA 60082362OtherWASHINGTON STATE DEPT OF HEALTH
WAPA 60082362OtherWASHINGTON STATE DEPT OF HEALTH