Provider Demographics
NPI:1629158019
Name:HARBERD, TOBE HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:TOBE
Middle Name:HOWARD
Last Name:HARBERD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 368
Mailing Address - Street 2:219 E. JOHNSON AVE.
Mailing Address - City:CHELAN
Mailing Address - State:WA
Mailing Address - Zip Code:98816-0368
Mailing Address - Country:US
Mailing Address - Phone:509-682-2511
Mailing Address - Fax:509-682-2515
Practice Address - Street 1:105 S APPLE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:CHELAN
Practice Address - State:WA
Practice Address - Zip Code:98816-8810
Practice Address - Country:US
Practice Address - Phone:509-682-6000
Practice Address - Fax:509-682-6192
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60078996207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2003430Medicaid
WAG8884611Medicare Oscar/Certification