Provider Demographics
NPI:1356227631
Name:FAIRBANKS, APRIL ANNE
Entity type:Individual
Prefix:
First Name:APRIL
Middle Name:ANNE
Last Name:FAIRBANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 STATE ROUTE 20
Mailing Address - Street 2:
Mailing Address - City:SEDRO WOOLLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98284-4322
Mailing Address - Country:US
Mailing Address - Phone:360-854-7400
Mailing Address - Fax:360-854-7445
Practice Address - Street 1:1420 STATE ROUTE 20
Practice Address - Street 2:
Practice Address - City:SEDRO WOOLLEY
Practice Address - State:WA
Practice Address - Zip Code:98284-4322
Practice Address - Country:US
Practice Address - Phone:360-854-7400
Practice Address - Fax:360-854-7445
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker