Provider Demographics
NPI:1639262629
Name:MOUG, ROBYN CLAIRE (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:CLAIRE
Last Name:MOUG
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26419 N NORTH RD
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-9368
Mailing Address - Country:US
Mailing Address - Phone:509-710-9825
Mailing Address - Fax:509-276-1455
Practice Address - Street 1:26419 N NORTH RD
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:WA
Practice Address - Zip Code:99006-9368
Practice Address - Country:US
Practice Address - Phone:509-710-9825
Practice Address - Fax:509-276-1455
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000061162251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology