Provider Demographics
NPI:1164689063
Name:FAUBION, KARA BETH (LMP)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:BETH
Last Name:FAUBION
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:BETH
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:KAPOWSIN
Mailing Address - State:WA
Mailing Address - Zip Code:98344-0011
Mailing Address - Country:US
Mailing Address - Phone:253-223-6137
Mailing Address - Fax:360-893-1881
Practice Address - Street 1:23103 86TH AVE E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-9118
Practice Address - Country:US
Practice Address - Phone:253-223-6137
Practice Address - Fax:360-893-1881
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017882174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist