| Doctor Name: | MR. ROBERT ALLEN HARTSOCK |
| NPI Number: | 1336398957 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CDP |
| License Number: | 976152 |
| Business Practice Address: | 2821 Mission Hill Rd Tulalip, WA - 982719706 |
| Business Phone Number: | 3607164313 |
| Business Fax Number: | 3606514404 |
| Mailing Address: | 1326 Potlatch Beach Rd, TULALIP |
| State: | WA |
| Postal Code: | 982716837 |
| Phone Number: | 3607164313 |
| Fax Number: | 3606514404 |
| NPI Enumeration Date: | 09/18/2008 |
| NPI Last Update Date: | 09/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 976152 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |