Provider Demographics
NPI:1578910204
Name:RINEHART, ROBERT JR
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:RINEHART
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 NE 78TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-9667
Mailing Address - Country:US
Mailing Address - Phone:360-771-4103
Mailing Address - Fax:
Practice Address - Street 1:1503 NE 78TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-9667
Practice Address - Country:US
Practice Address - Phone:360-771-4103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60533848174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist