Healthcare Provider Details

I. General information

NPI: 1073176905
Provider Name (Legal Business Name): ROBIN PETER BERGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2019
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UW MEDICAL CENTER 1959 NE PACIFIC STREET
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

3519 NE 113TH ST
SEATTLE WA
98125-5738
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-3300
  • Fax:
Mailing address:
  • Phone: 206-773-5303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD61186187
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: