Kenneth R. Fabert, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00040512 Issued in WA

Practice address

19379 7TH Ave NE
Poulsbo, WA 98370-7504

Phone

(360) 394-1000

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1023164944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34584",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241584",
            "telephone_number": "509-241-7349",
            "fax_number": "509-241-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19379 7TH AVE NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707504",
            "telephone_number": "360-394-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABERT",
        "first_name": "KENNETH",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00040512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8323545",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Empowersyou Counseling Services
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• Brandon Escobar, OT
• Barbara Evans, LMP
• Adam Joseph Fairbanks, LMT
• Samuel Falana, PHARM D
• Emily Farish, L.AC
• Debra Lillian Fasel, LMP
• Lindzey Faust, DO

• Family Medicine Physician in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.