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General NPI Number Information
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NPI Number | 1225209851
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Entity Type | Individual
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Provider Name | ROBIN RANEE LOUBERT PAC
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Gender | Female
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 17500 SE 392ND ST
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City | AUBURN
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State | WA
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Zip | 98092-9705
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Country | US
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Telephone | 253-939-6648
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Fax |
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Provider Business Mailing Address
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Address Line | 4448 SASSE RD
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City | HEMLOCK
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State | MI
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Zip | 48626-9520
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Country | US
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Telephone | 989-928-2078
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60973755
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601004440
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License Number State | MI
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