Provider Demographics
NPI:1518063312
Name:HADDAD, ROBERT G (DC, RPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:HADDAD
Suffix:
Gender:M
Credentials:DC, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 E ROWAN AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1214
Mailing Address - Country:US
Mailing Address - Phone:509-487-6222
Mailing Address - Fax:509-487-6333
Practice Address - Street 1:124 E ROWAN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1214
Practice Address - Country:US
Practice Address - Phone:509-487-6222
Practice Address - Fax:509-487-6333
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034503111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8887177Medicare PIN