Healthcare Provider Details

I. General information

NPI: 1669392551
Provider Name (Legal Business Name): TINA MARIE ROBLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 W MAIN ST
MONROE WA
98272-2028
US

IV. Provider business mailing address

17303 14TH DR SE
BOTHELL WA
98012-5108
US

V. Phone/Fax

Practice location:
  • Phone: 415-412-3147
  • Fax:
Mailing address:
  • Phone: 415-412-3147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: