Provider Demographics
NPI:1003416538
Name:MOLATO, ROBERT MARTINEZ (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MARTINEZ
Last Name:MOLATO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1946 4TH AVE E
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4632
Mailing Address - Country:US
Mailing Address - Phone:910-546-3318
Mailing Address - Fax:
Practice Address - Street 1:1946 4TH AVE E
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4632
Practice Address - Country:US
Practice Address - Phone:360-352-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61101226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor