Fabian T Spencer

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000104602 Issued in OR

Practice address

46314 Timine Way
Pendleton, OR 97801-9417

Phone

(541) 966-9830

NPI assigned

Mar 26, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1942887757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010160",
            "telephone_number": "154-196-6983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46314 TIMINE WAY",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978019417",
            "telephone_number": "541-966-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "FABIAN",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000104602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rosettaminthorn@yellowhawk.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "46314 Timine Way",
            "city": "Pendleton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "978019417",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rosettaminthorn@yellowhawk.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "46314 Timine Way",
            "city": "Pendleton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "978019417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sharyn Smith
• Shilo Caramay Smith, L.C.S.W.
• Tia Patricia Smith, B.S. QHMA
• Timothy Blair Smith, DMD
• Sarah Whitney Sparks, MA
• Joan Idella Spitzer, RN
• Terry Eugene Sprague
• St Anthony Hospital
• St Anthony Hospital
• St Anthony Hospital

• Peer Specialist in Pendleton, OR
• Providers in Pendleton, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.