Healthcare Provider Details

I. General information

NPI: 1417111030
Provider Name (Legal Business Name): ROBYN PILBEAM LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2008
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 W CLEARWATER AVE STE F
KENNEWICK WA
99336-2767
US

IV. Provider business mailing address

777 MCMURRAY ST APT 16
RICHLAND WA
99354-2266
US

V. Phone/Fax

Practice location:
  • Phone: 509-591-8338
  • Fax: 509-783-6675
Mailing address:
  • Phone: 509-591-8338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00024762
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: