Healthcare Provider Details

I. General information

NPI: 1689672552
Provider Name (Legal Business Name): ROBERT GREGG BILLOW D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 M AVE STE C
ANACORTES WA
98221-3897
US

IV. Provider business mailing address

1211 24TH ST
ANACORTES WA
98221-2562
US

V. Phone/Fax

Practice location:
  • Phone: 360-299-4929
  • Fax: 360-299-4930
Mailing address:
  • Phone: 360-299-1378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOP00001735
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: