Healthcare Provider Details

I. General information

NPI: 1649701020
Provider Name (Legal Business Name): CHRISTOPHER AARON ROBERTS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 S PIONEER WAY
MOSES LAKE WA
98837-4613
US

IV. Provider business mailing address

1616 S PIONEER WAY
MOSES LAKE WA
98837-2487
US

V. Phone/Fax

Practice location:
  • Phone: 509-793-9794
  • Fax: 509-764-3270
Mailing address:
  • Phone: 509-793-9715
  • Fax: 509-764-3244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD61296318
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: