Healthcare Provider Details

I. General information

NPI: 1134832488
Provider Name (Legal Business Name): ROBIN PATRICK GROPP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 01/03/2023
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2133 3RD AVE STE 116
SEATTLE WA
98121-2353
US

IV. Provider business mailing address

3123 17TH AVE S
SEATTLE WA
98144-5806
US

V. Phone/Fax

Practice location:
  • Phone: 206-432-3574
  • Fax:
Mailing address:
  • Phone: 360-317-8303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: