Provider Demographics
NPI:1972693935
Name:GOLDSTEIN, ROBERT B (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6703 W RIO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2623
Mailing Address - Country:US
Mailing Address - Phone:509-460-5918
Mailing Address - Fax:509-736-1503
Practice Address - Street 1:6703 W RIO GRANDE AVE
Practice Address - Street 2:BLDG A
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2623
Practice Address - Country:US
Practice Address - Phone:509-460-5918
Practice Address - Fax:509-736-1503
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039823174400000X
MT100928207L00000X
WAMD 00039823207L00000X
ORMD218382207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA348352OtherWA LABOR & INDUSTRIES
WAP01575139OtherRAILROAD MEDICARE
WA348352OtherWA LABOR & INDUSTRIES