Provider Demographics
NPI:1073569612
Name:BOND, ROBERT E (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:BOND
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1511 W MARC DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2732
Mailing Address - Country:US
Mailing Address - Phone:509-434-7006
Mailing Address - Fax:509-434-7115
Practice Address - Street 1:4815 N ASSEMBLY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6185
Practice Address - Country:US
Practice Address - Phone:509-434-7006
Practice Address - Fax:509-434-7115
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10004493363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCVADOOMedicare UPIN