Provider Demographics
NPI:1609922103
Name:ROBINSON, INGRID (LMP)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4908
Mailing Address - Country:US
Mailing Address - Phone:360-927-1612
Mailing Address - Fax:866-720-5402
Practice Address - Street 1:1155 N STATE ST STE 414
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5024
Practice Address - Country:US
Practice Address - Phone:360-927-1612
Practice Address - Fax:866-720-5402
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017953225700000X
WALH60814974101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist