Healthcare Provider Details

I. General information

NPI: 1801981766
Provider Name (Legal Business Name): ROBERT STANLEY DOBRES M.S.W., L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KAISER PERMANENTE EASTMAN PARKWAY OFFICE 1550 NW EASTMAN PARKWAY
GRESHAM OR
97030
US

IV. Provider business mailing address

KAISER PERMANENTE EASTMAN PARKWAY OFFICE 1550 NW EASTMAN PARKWAY
GRESHAM OR
97030
US

V. Phone/Fax

Practice location:
  • Phone: 503-571-0777
  • Fax:
Mailing address:
  • Phone: 503-571-0777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberL3310
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: