Healthcare Provider Details

I. General information

NPI: 1013118652
Provider Name (Legal Business Name): ROBERT H PRICE MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10315 19TH AVE SE STE 112
EVERETT WA
98208-4268
US

IV. Provider business mailing address

10315 19TH AVE SE STE 112
EVERETT WA
98208-4268
US

V. Phone/Fax

Practice location:
  • Phone: 425-379-7191
  • Fax: 425-379-8271
Mailing address:
  • Phone: 425-379-7191
  • Fax: 425-379-8271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD00025709
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License NumberMD00025709
License Number StateWA

VIII. Authorized Official

Name: DR. ROBERT H. PRICE
Title or Position: MANAGER
Credential: MD
Phone: 425-379-7191