Provider Demographics
NPI:1437185279
Name:RUBENSTEIN, ROBERT SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:SCOTT
Last Name:RUBENSTEIN
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 1:9621 RIDGETOP BLVD NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383
Mailing Address - Country:US
Mailing Address - Phone:360-830-1605
Mailing Address - Fax:
Practice Address - Street 1:2011 NW MYHRE PL
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8561
Practice Address - Country:US
Practice Address - Phone:360-830-1605
Practice Address - Fax:360-830-1693
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000284632084N0600X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RU7128OtherREGENCE BLUESHIELD
WA75447OtherLABOR & INDUSTRIES
5093015OtherAETNA
WA8128423Medicaid
130005979OtherRAILROAD MEDICARE
WA8935763OtherCRIME VICTIMS COMP
BR2366498OtherDEA
WAG8852226Medicare PIN
BR2366498OtherDEA
E63900Medicare UPIN
WA8128423Medicaid
WAG115136438Medicare PIN
WAG000250627Medicare PIN
RU7128OtherREGENCE BLUESHIELD
WAGAB05197Medicare PIN