Kenneth R Sebby, MD

Individual provider Active NPI Orthopaedic Surgery Physician · Union, WA

NPI 1881703643 · NPPES record last updated May 15, 2013

Key facts

NPI
1881703643
Entity type
Individual (NPI type 1)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
License
MD00031767 (WA)
Practice address
100 E Madrona Beach LN
Union, WA 98592-0621
Phone
(360) 898-0261
Fax
(360) 357-9392
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12481NEMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD00031767 WA Yes

Addresses

Primary practice location

100 E Madrona Beach LN
Union, WA 98592-0621

Mailing address

100 E Madrona Beach LN
Pob 621
Union, WA 98592
Phone (360) 898-0261

Other identifiers

IdentifierTypeStateIssuer
1116243MedicaidWA
162846OtherL AND I

Other providers in Union, WA

All providers in Union, WA · Orthopaedic Surgery Physician in Washington

Sources for this page

Verify at the official NPI Registry.