Provider Demographics
NPI:1356309363
Name:MCLEES, ROBERT Z (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:Z
Last Name:MCLEES
Suffix:
Gender:M
Credentials:MD
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 8550
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98419-0550
Mailing Address - Country:US
Mailing Address - Phone:253-475-5433
Mailing Address - Fax:253-473-6715
Practice Address - Street 1:2201 S 19TH ST
Practice Address - Street 2:STE #101
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2962
Practice Address - Country:US
Practice Address - Phone:253-475-5433
Practice Address - Fax:253-473-6715
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00014542207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1015783Medicaid
WA001001455Medicare ID - Type Unspecified
WA1015783Medicaid