Provider Demographics
NPI:1740389519
Name:BURROWS, ROBERT P (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:BURROWS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1126
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-0169
Mailing Address - Country:US
Mailing Address - Phone:360-748-9228
Mailing Address - Fax:360-748-4617
Practice Address - Street 1:1179 S MARKET BLVD
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3427
Practice Address - Country:US
Practice Address - Phone:360-748-9228
Practice Address - Fax:360-748-4617
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00001416152W00000X, 152WC0802X
WA00001416152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2030237Medicaid
WA0036580OtherL&I CLINIC GROUP NUMBER
WA0052484OtherL&I RPBURROWS ONLY
WA2046506Medicaid
WABU0836OtherREGENCE RPBURROWS ONLY
WAHE7836OtherREGENCE CLINIC NUMBER
WABU0836OtherREGENCE RPBURROWS ONLY
WAG115144700Medicare Oscar/Certification
WAHE7836OtherREGENCE CLINIC NUMBER
WAT02626Medicare UPIN