Provider Demographics
NPI:1336132414
Name:ROBERTSON, ERIN L (PT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:L
Other - Last Name:GEERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 2170
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-0480
Mailing Address - Country:US
Mailing Address - Phone:253-840-2313
Mailing Address - Fax:253-840-6340
Practice Address - Street 1:32030 23RD AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6031
Practice Address - Country:US
Practice Address - Phone:253-946-4852
Practice Address - Fax:253-946-4862
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4542GEOtherREGENCE B/S
WA8372716Medicaid
WAP00004295OtherR/R MED KING COUNTY
WA169253OtherDEPT OF L&I
WA8934687OtherCRIME VICTIMS
WA169253OtherDEPT OF L&I
WA4542GEOtherREGENCE B/S