Individual provider Active NPI

Gilberto R Fernandez

  • Counselor
  • Aberdeen, WA
National Provider Identifier
1619206711
Registry record updated Dec 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
RC00024829 Issued in WA
Practice address
1813 Sumner Ave
Aberdeen, WA 98520-4600
Phone
(360) 538-1461
Fax
(360) 537-4202
NPI assigned
Dec 18, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X RC00024829 WA Primary

Addresses

Primary practice location

1813 Sumner Ave
Aberdeen, WA 98520-4600

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-3335

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
RC00024829WAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1261094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261094400000",
    "number": "1619206711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-3335",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1813 SUMNER AVE",
            "city": "ABERDEEN",
            "state": "WA",
            "postal_code": "985204600",
            "telephone_number": "360-538-1461",
            "fax_number": "360-537-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "GILBERTO",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-18",
        "last_updated": "2009-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC00024829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2009; 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.