Provider Demographics
NPI:1114938883
Name:THORPE, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:THORPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1708 YAKIMA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-5307
Mailing Address - Country:US
Mailing Address - Phone:253-627-9151
Mailing Address - Fax:253-591-8892
Practice Address - Street 1:1708 YAKIMA AVE
Practice Address - Street 2:STE 100
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5307
Practice Address - Country:US
Practice Address - Phone:253-627-9151
Practice Address - Fax:253-591-8892
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00035180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8930019OtherSTATE CRIME VICTIMS
WA0126523OtherSTATE L&I
WA80138451OtherMEDICARE RAILROAD
WA8210866Medicaid
WA8930019OtherSTATE CRIME VICTIMS
C51951Medicare UPIN