Healthcare Provider Details

I. General information

NPI: 1538175476
Provider Name (Legal Business Name): ROBERT J SNYDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 01/18/2021
Certification Date: 01/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34709 9TH AVE S STE B-500
FEDERAL WAY WA
98003-6789
US

IV. Provider business mailing address

34709 9TH AVE S STE B500
FEDERAL WAY WA
98003-6789
US

V. Phone/Fax

Practice location:
  • Phone: 253-944-6950
  • Fax: 253-661-8603
Mailing address:
  • Phone: 253-835-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD00030141
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: