Provider Demographics
NPI:1366641185
Name:JOSEPH J. ROBIN MD PS
Entity Type:Organization
Organization Name:JOSEPH J. ROBIN MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-455-5440
Mailing Address - Street 1:1600 116TH AVE NE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3014
Mailing Address - Country:US
Mailing Address - Phone:425-455-5440
Mailing Address - Fax:425-455-1431
Practice Address - Street 1:1600 116TH AVE NE
Practice Address - Street 2:SUITE 302
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3014
Practice Address - Country:US
Practice Address - Phone:425-455-5440
Practice Address - Fax:425-455-1431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00015699174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1247600Medicaid
WA1247600Medicaid