Provider Demographics
NPI:1316032030
Name:RICE, ROBIN A (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:A
Last Name:RICE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532
Mailing Address - Country:US
Mailing Address - Phone:360-748-0211
Mailing Address - Fax:360-740-4170
Practice Address - Street 1:305 LINHART AVE NE
Practice Address - Street 2:
Practice Address - City:NAPAVINE
Practice Address - State:WA
Practice Address - Zip Code:98565
Practice Address - Country:US
Practice Address - Phone:360-262-3990
Practice Address - Fax:360-740-4170
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10004393363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9090RIOtherREGENCE
WA0171390OtherLABOR & INDUSTRIES
P00036748OtherRAILROAD MEDICARE
GAB38151Medicare PIN
P00036748OtherRAILROAD MEDICARE
GAB38170Medicare PIN