Healthcare Provider Details

I. General information

NPI: 1972965481
Provider Name (Legal Business Name): ROBERT BRANDON HAUSS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6442 YAKIMA AVE
TACOMA WA
98408-4599
US

IV. Provider business mailing address

6442 YAKIMA AVE
TACOMA WA
98408-4599
US

V. Phone/Fax

Practice location:
  • Phone: 253-459-7270
  • Fax: 253-472-6833
Mailing address:
  • Phone: 253-459-7270
  • Fax: 253-472-6833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberOP60965951
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: