Healthcare Provider Details

I. General information

NPI: 1285697573
Provider Name (Legal Business Name): CHESTER MARK ROBACHINSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 12TH AVE
SEATTLE WA
98122-4410
US

IV. Provider business mailing address

818 12TH AVE
SEATTLE WA
98122-4410
US

V. Phone/Fax

Practice location:
  • Phone: 206-328-8216
  • Fax: 206-726-1878
Mailing address:
  • Phone: 206-328-8216
  • Fax: 206-726-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD00027330
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: