Healthcare Provider Details

I. General information

NPI: 1033370705
Provider Name (Legal Business Name): ROBYN B. VERA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 NW MYHRE RD
SILVERDALE WA
98383-7662
US

IV. Provider business mailing address

4230 BRIDGEPORT WAY W STE B
UNIVERSITY PLACE WA
98466-4335
US

V. Phone/Fax

Practice location:
  • Phone: 564-240-3100
  • Fax: 564-240-3198
Mailing address:
  • Phone: 253-779-6301
  • Fax: 253-627-8792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberOP 60274192
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: