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General NPI Number Information
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NPI Number | 1134004518
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Entity Type | Individual
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Provider Name | JUWUAN PHOMPRIDA-ROBINSON
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Gender | Male
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Dates
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Enumeration Date | 08/06/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 319 WASHINGTON AVE S
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City | KENT
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State | WA
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Zip | 98032-5767
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Country | US
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Telephone | 253-264-0093
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Fax | 253-264-0093
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Provider Business Mailing Address
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Address Line | 12530 69TH AVE S
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City | SEATTLE
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State | WA
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Zip | 98178-4127
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Country | US
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Telephone | 206-898-8048
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State | WA
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