Provider Demographics
NPI:1508593716
Name:LONE, ROBERT FREDERICK JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FREDERICK
Last Name:LONE
Suffix:JR
Gender:M
Credentials:PHD
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 361
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98035-0361
Mailing Address - Country:US
Mailing Address - Phone:253-232-8678
Mailing Address - Fax:
Practice Address - Street 1:26261 41ST PL S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-7151
Practice Address - Country:US
Practice Address - Phone:253-520-6536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60871703103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist