Individual
ALBERT O FABIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
176 1ST AVE N, PO DRAWER N, ILWACO, WA 98624
(360) 642-3747
(360) 642-3361
Mailing address
PO BOX H, ILWACO, WA 98624-0258
(360) 642-3747
(360) 642-3361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00042733
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184330
L & I
WA
01
—
2855FA
BCBS
WA
Enumeration date
09/12/2005
Last updated
05/21/2020
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