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NPI Code Detail

MEDICARE: MR. ROBERT E GANT

MEDICARE: MR. ROBERT E GANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorRC00036512WA

General Provider Information

NPI Number : 1184865081
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT E GANT
Provider Business Mailing Address
First Line : 4555 DELRIDGE WAY SW
Second Line :
City : SEATTLE
State : WA
Zip : 98106-1379
Country : US
Telephone Number : 206-937-7680
Fax Number : 206-935-9967
Provider Business Practice Location Address
First Line : 4555 DELRIDGE WAY SW
Second Line :
City : SEATTLE
State : WA
Zip : 98106-1379
Country : US
Telephone Number : 206-937-7680
Fax Number : 206-935-9967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2009
Last Update Date : 03/23/2009

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Directions to “ MR. ROBERT E GANT ” Practice Location

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