MEDICARE: DR. DOUGLAS P ROBINSON M.D.

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
1	2084F0202X	Forensic Psychiatry Physician	MD00016044	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MD00016044	OTHER	WA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1205994597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOUGLAS P ROBINSON M.D.

Provider Business Mailing Address
First Line	:	6215 22ND AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-6917
Country	:	US
Telephone Number	:	206-860-2432
Fax Number	:	206-770-6532

Provider Business Practice Location Address
First Line	:	2910 E MADISON ST
Second Line	:	SUITE 104
City	:	SEATTLE
State	:	WA
Zip	:	98112-4214
Country	:	US
Telephone Number	:	206-860-2432
Fax Number	:	206-770-6532

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/08/2007

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