Doctor Name: | MR. DESHAWN MICHAEL ROBERSON |
NPI Number: | 1043603400 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 4311 11th Ave Ne Suite 200 Seattle, WA - 98105 |
Business Phone Number: | 6198207062 |
Business Fax Number: | |
Mailing Address: | 4311 11th Ave Ne, Suite 200 SEATTLE |
State: | WA |
Postal Code: | 98105 |
Phone Number: | 6198207062 |
Fax Number: | |
NPI Enumeration Date: | 03/10/2015 |
NPI Last Update Date: | 03/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |