Individual
CARRIE LEE FAIRBAIRN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 OCEAN AVE, RAYMOND, WA 98577-3016
(360) 942-3040
(360) 942-3955
Mailing address
1407 LAUREL ST, HOQUIAM, WA 98550-1070
(503) 990-9068
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
WA
175T00000X
Peer Specialist
—
WA
Other
Enumeration date
03/23/2022
Last updated
06/14/2024
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