Healthcare Provider Details
I. General information
NPI: 1336267806
Provider Name (Legal Business Name): KARA FAIRBANKS WARDEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/26/2007
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3901 HOYT AVE
EVERETT WA
98201-4918
US
IV. Provider business mailing address
7600 EVERGREEN WAY
EVERETT WA
98203-6421
US
V. Phone/Fax
- Phone: 425-339-5408
- Fax:
- Phone: 206-860-5414
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207WX0109X |
| Taxonomy | Neuro-ophthalmology Physician |
| License Number | MD60181780 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: