Provider Demographics
NPI:1144399940
Name:HOUSTON, ROBERT BOYD (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BOYD
Last Name:HOUSTON
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 1:1017 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-4105
Mailing Address - Country:US
Mailing Address - Phone:360-293-6611
Mailing Address - Fax:360-299-2021
Practice Address - Street 1:1017 7TH ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-4105
Practice Address - Country:US
Practice Address - Phone:360-293-6611
Practice Address - Fax:360-299-2021
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA821111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
17249OtherREGENCE
WA2418309Medicaid
12939OtherL AND I