| Doctor Name: | MS. ANNETTE FLY |
| NPI Number: | 1134480056 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | AP60375338 |
| Business Practice Address: | 1300 Ne Goldie St Oak Harbor, WA - 982774832 |
| Business Phone Number: | 3606795590 |
| Business Fax Number: | |
| Mailing Address: | Po Box 3603, SEATTLE |
| State: | WA |
| Postal Code: | 981243603 |
| Phone Number: | 2063716289 |
| Fax Number: | |
| NPI Enumeration Date: | 06/07/2012 |
| NPI Last Update Date: | 01/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP60375338 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |