1740563204 NPI number — DAWN M ROBINS M.A. MFT

Table of content: DAWN M ROBINS M.A. MFT (NPI 1740563204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740563204 NPI number — DAWN M ROBINS M.A. MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINS
Provider First Name:
DAWN
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A. MFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740563204
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/31/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6605 SEABECK HOLLY RD NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEABECK
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98380-8876
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-406-3860
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10535 POPS PL NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEABECK
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98380-4503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-406-3860
Provider Business Practice Location Address Fax Number:
360-550-4337
Provider Enumeration Date:
09/21/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  41312 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: LF60931791 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: MFT41312 . This is a "BOARD OF BEHAVIORAL SCIENCES LICENSE MARRIAGE & FAMILY THERAPIST" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: LF60931791 . This is a "WASHINGTON STATE DEPARTMENT OF HEALTH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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