Provider Demographics
NPI:1013004662
Name:SANDS, ROBERT EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EDWARD
Last Name:SANDS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3609 SO 19TH ST
Mailing Address - Street 2:ROBERT E SANDS MD
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405
Mailing Address - Country:US
Mailing Address - Phone:253-752-6056
Mailing Address - Fax:253-759-7129
Practice Address - Street 1:3609 SO 19TH ST
Practice Address - Street 2:ROBERT E SANDS MD
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-752-6056
Practice Address - Fax:253-759-7129
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA25200M000150922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
200227OtherSTATE PROVIDER #
T64237OtherTIN
BS1105964OtherDEA
BS1105964OtherDEA