Healthcare Provider Details

I. General information

NPI: 1346205275
Provider Name (Legal Business Name): ROBERT NAVARRO MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 BONNIE LN
TOPPENISH WA
98948-1005
US

IV. Provider business mailing address

1405 BONNIE LN
TOPPENISH WA
98948-1005
US

V. Phone/Fax

Practice location:
  • Phone: 509-865-5868
  • Fax: 509-865-4297
Mailing address:
  • Phone: 509-865-5868
  • Fax: 509-865-4297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: