Provider Demographics
NPI:1750592960
Name:BINGER, ROBERT BRUCE (DC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRUCE
Last Name:BINGER
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 1:2709 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-7212
Mailing Address - Country:US
Mailing Address - Phone:253-627-7777
Mailing Address - Fax:
Practice Address - Street 1:2709 6TH AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-7212
Practice Address - Country:US
Practice Address - Phone:253-627-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2049807Medicaid
WA2049807Medicaid