Healthcare Provider Details

I. General information

NPI: 1588646699
Provider Name (Legal Business Name): ROBERT CARL RINKE PT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 04/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12811 8TH AVE W A-205
EVERETT WA
98204-6335
US

IV. Provider business mailing address

12811 8TH AVE W A-205
EVERETT WA
98204-6335
US

V. Phone/Fax

Practice location:
  • Phone: 425-348-1259
  • Fax: 425-348-3071
Mailing address:
  • Phone: 425-348-1259
  • Fax: 425-348-3071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH00003112
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number23964
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT00006248
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT12673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: