MEDICARE: KAREN E. HIBBERT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD00036428	WA

General Provider Information

NPI Number	:	1710977194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN E. HIBBERT M.D.

Provider Business Mailing Address
First Line	:	19401 40TH AVE W
Second Line	:	SUITE 100
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-4612
Country	:	US
Telephone Number	:	425-744-7153
Fax Number	:

Provider Business Practice Location Address
First Line	:	19401 40TH AVE W
Second Line	:	SUITE 100
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-4612
Country	:	US
Telephone Number	:	425-744-7153
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	08/29/2007

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