Provider Demographics
NPI:1225439532
Name:ROBINSON, STACIA LAINE (DPT)
Entity Type:Individual
Prefix:
First Name:STACIA
Middle Name:LAINE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8862 BENDER RD
Mailing Address - Street 2:STE 101
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-8800
Mailing Address - Country:US
Mailing Address - Phone:509-540-4657
Mailing Address - Fax:
Practice Address - Street 1:8862 BENDER RD
Practice Address - Street 2:STE 101
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-8800
Practice Address - Country:US
Practice Address - Phone:360-354-1115
Practice Address - Fax:360-354-0321
Is Sole Proprietor?:No
Enumeration Date:2014-09-07
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016929225100000X
WAPT60502552225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist