| Doctor Name: | ALBERT KENNETH JABBOUR |
| NPI Number: | 1013131119 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 516 |
| Business Practice Address: | 30410 Highway 200 Ponderay, ID - 838529601 |
| Business Phone Number: | 2082637101 |
| Business Fax Number: | 2082637198 |
| Mailing Address: | Po Box 2160, SANDPOINT |
| State: | ID |
| Postal Code: | 838640908 |
| Phone Number: | 2082637101 |
| Fax Number: | 2082637198 |
| NPI Enumeration Date: | 04/12/2007 |
| NPI Last Update Date: | 03/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 516 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |