Provider Demographics
NPI:1801107990
Name:DRAGOTTI, ROBERT JUAN JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JUAN JOSEPH
Last Name:DRAGOTTI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 168TH ST NE STE B205
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8465
Mailing Address - Country:US
Mailing Address - Phone:360-322-6375
Mailing Address - Fax:360-322-6974
Practice Address - Street 1:3710 168TH ST NE STE B205
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8465
Practice Address - Country:US
Practice Address - Phone:360-322-6375
Practice Address - Fax:360-322-6974
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60528179208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery