Healthcare Provider Details

I. General information

NPI: 1972532448
Provider Name (Legal Business Name): DEBORAH KAYE ROBERTSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 JACKSON AVE
TACOMA WA
98431-0001
US

IV. Provider business mailing address

9040A JACKSON AVE JOINT BASE LEWIS-MCCORD
TACOMA WA
98431-0001
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-0010
  • Fax:
Mailing address:
  • Phone: 253-968-3070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number138771-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: