Individual provider Active NPI

Fernando Libor, REGISTERED NURSE

  • Registered Nurse
  • Tukwila, WA
National Provider Identifier
1043021140
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
61342809 Issued in WA
Practice address
3900 Southcenter Blvd Apt B5
Tukwila, WA 98188-2279
Phone
(360) 271-4003
NPI assigned
Jan 17, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 61342809 WA Primary

Addresses

Primary practice location

3900 Southcenter Blvd Apt B5
Tukwila, WA 98188-2279

Mailing address

3900 Southcenter Blvd Apt B5
Tukwila, WA 98188-2279
Phone (360) 271-4003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61342809WAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1043021140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 SOUTHCENTER BLVD APT B5",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882279",
            "telephone_number": "360-271-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 SOUTHCENTER BLVD APT B5",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882279",
            "telephone_number": "360-271-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBOR",
        "first_name": "FERNANDO",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "61342809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.