Provider Demographics
NPI:1699852517
Name:DR ROBYN R DESAUTEL INC PS
Entity Type:Organization
Organization Name:DR ROBYN R DESAUTEL INC PS
Other - Org Name:DESAUTEL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:RACHELLE
Authorized Official - Last Name:DESAUTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-932-3718
Mailing Address - Street 1:5902 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1650
Mailing Address - Country:US
Mailing Address - Phone:206-932-3718
Mailing Address - Fax:206-937-6718
Practice Address - Street 1:5902 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1650
Practice Address - Country:US
Practice Address - Phone:206-932-3718
Practice Address - Fax:206-937-6718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003010111N00000X
WAMA00021700225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
452131Medicare UPIN