Provider Demographics
NPI:1356458558
Name:ROBIN, JOSEPH JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JAY
Last Name:ROBIN
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 1:1600 116TH AVE NE STE 302
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3057
Mailing Address - Country:US
Mailing Address - Phone:425-455-5440
Mailing Address - Fax:425-455-1431
Practice Address - Street 1:1600 116TH AVE NE STE 302
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3057
Practice Address - Country:US
Practice Address - Phone:425-455-5440
Practice Address - Fax:425-455-1431
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000156992084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1247600Medicaid
WAA05484Medicare UPIN
WA1247600Medicaid