Provider Demographics
NPI:1669211041
Name:SAWIN, ROBERT MALCOLM III (MS)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MALCOLM
Last Name:SAWIN
Suffix:III
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3471 N TAMAR RD
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-1209
Mailing Address - Country:US
Mailing Address - Phone:760-685-0173
Mailing Address - Fax:
Practice Address - Street 1:341 W TUDOR RD STE 209
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6648
Practice Address - Country:US
Practice Address - Phone:907-331-0576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health