Individual provider Active NPI

Khalid Abdul Jaboori, M.D.

  • Family Medicine Physician
  • Port Angeles, WA
National Provider Identifier
1114126562
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
60280758 Issued in WA
Practice address
1 Ediz Hook
Port Angeles, WA 98362-2201
Phone
(253) 292-7500
Fax
(360) 417-5899
NPI assigned
Jul 16, 2007
Last updated
May 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24329 NE
Family Medicine Physician 207Q00000X 60280758 WA Primary

Addresses

Primary practice location

1 Ediz Hook
Port Angeles, WA 98362-2201

Mailing address

Madigan Army Medical Center
BLDG 9040 Fitzsimmons Drive
Tacoma, WA 98431-0001
Phone (202) 316-4322

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
24329NEMDFamily Medicine Physician
60280758WAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1114126562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER",
            "address_2": "BLDG 9040 FITZSIMMONS DRIVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "202-316-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDIZ HOOK",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622201",
            "telephone_number": "253-292-7500",
            "fax_number": "360-417-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABOORI",
        "first_name": "KHALID",
        "middle_name": "ABDUL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-16",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "24329",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "60280758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.