Provider Demographics
NPI:1114070737
Name:PEEPLES, ROBERT MICHAEL (PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MICHAEL
Last Name:PEEPLES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1744 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-4702
Mailing Address - Country:US
Mailing Address - Phone:360-733-5155
Mailing Address - Fax:360-733-1165
Practice Address - Street 1:1744 IOWA ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-4702
Practice Address - Country:US
Practice Address - Phone:360-733-5155
Practice Address - Fax:360-733-1165
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6844225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0206043OtherLABOR AND INDUSTRIES
WA7228792OtherAETNA
WA3370ROOtherREGENCE
WA0206043OtherLABOR AND INDUSTRIES