Provider Demographics
NPI:1578518783
Name:SPEIGEL, ROBERT BARRY (MSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BARRY
Last Name:SPEIGEL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 S DAWSON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2100
Mailing Address - Country:US
Mailing Address - Phone:206-232-9474
Mailing Address - Fax:866-515-6840
Practice Address - Street 1:5100 S DAWSON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2100
Practice Address - Country:US
Practice Address - Phone:206-232-9474
Practice Address - Fax:866-515-6840
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000065181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8861344Medicare ID - Type Unspecified