Provider Demographics
NPI:1477362846
Name:ROBERT, STEPHANE PAUL (PT, DPT)
Entity type:Individual
Prefix:
First Name:STEPHANE
Middle Name:PAUL
Last Name:ROBERT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7944 139TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3228
Mailing Address - Country:US
Mailing Address - Phone:425-577-2316
Mailing Address - Fax:
Practice Address - Street 1:1700 CALIFORNIA ST STE 530
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4591
Practice Address - Country:US
Practice Address - Phone:415-921-1758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA306373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist