Provider Demographics
NPI:1063855856
Name:ROBINSON, DUGGAN GRANT (DC)
Entity Type:Individual
Prefix:
First Name:DUGGAN
Middle Name:GRANT
Last Name:ROBINSON
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 1:26832 MAPLE VALLEY BLACK DIAMOND RD SE
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-8309
Mailing Address - Country:US
Mailing Address - Phone:254-433-6583
Mailing Address - Fax:425-433-6573
Practice Address - Street 1:26832 MAPLE VALLEY BLACK DIAMOND RD SE
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038
Practice Address - Country:US
Practice Address - Phone:425-433-6583
Practice Address - Fax:425-433-6573
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH06151354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor