Provider Demographics
NPI:1225163439
Name:COLLINS, ROBERT BRYANT (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRYANT
Last Name:COLLINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7425 166TH AVE NE STE C220
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7867
Mailing Address - Country:US
Mailing Address - Phone:425-558-4500
Mailing Address - Fax:
Practice Address - Street 1:7425 166TH AVE NE STE C220
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7867
Practice Address - Country:US
Practice Address - Phone:425-558-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1077TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMC 1375991OtherDEA #
WAT03095Medicare UPIN
WA8850949Medicare ID - Type Unspecified