Provider Demographics
NPI:1669478137
Name:MORASCH, ROBERT G (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:G
Last Name:MORASCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1644 PLAZA WAY # 427
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4325
Mailing Address - Country:US
Mailing Address - Phone:949-933-9644
Mailing Address - Fax:888-571-1801
Practice Address - Street 1:1129 S 2ND AVE STE B
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4100
Practice Address - Country:US
Practice Address - Phone:509-520-5520
Practice Address - Fax:888-571-1801
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00041082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0236040OtherL&I
WA8355877Medicaid
WAG8873694Medicare PIN