Provider Demographics
NPI:1336251040
Name:HALE, ROBERT G (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:HALE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 SIMPSON AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-4333
Mailing Address - Country:US
Mailing Address - Phone:360-533-8770
Mailing Address - Fax:360-533-5650
Practice Address - Street 1:2700 SIMPSON AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-4333
Practice Address - Country:US
Practice Address - Phone:360-533-8770
Practice Address - Fax:360-533-5650
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17697111N00000X
CO3949111N00000X
WA2104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAHA8516OtherREGENCE BC/BS
WA65345OtherDEPT OF LABOR AND INDUSTR
WA65345OtherDEPT OF LABOR AND INDUSTR