Healthcare Provider Details

I. General information

NPI: 1316245111
Provider Name (Legal Business Name): ROBERT DUSTIN DEWITT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BROADWAY
BELLINGHAM WA
98225-3036
US

IV. Provider business mailing address

16111 PLUMMER ST BLDG 10B-A109
NORTH HILLS CA
91343-2036
US

V. Phone/Fax

Practice location:
  • Phone: 360-922-6977
  • Fax:
Mailing address:
  • Phone: 818-891-7711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: