Provider Demographics
NPI:1093739500
Name:ROBINSON, JUSTIN A (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:A
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2947
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98907-2947
Mailing Address - Country:US
Mailing Address - Phone:509-248-7849
Mailing Address - Fax:509-249-5042
Practice Address - Street 1:3999 ENGLEWOOD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-6334
Practice Address - Country:US
Practice Address - Phone:509-453-4614
Practice Address - Fax:509-453-3468
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00025728208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery