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General NPI Number Information
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NPI Number | 1619056520
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Entity Type | Individual
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Provider Name | ALDEN WARREN ROBERTS MD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 203 SE PARK PLAZA DR STE 140
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City | VANCOUVER
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State | WA
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Zip | 98684-5886
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Country | US
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Telephone | 360-449-7031
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Fax | 360-449-7053
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Provider Business Mailing Address
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Address Line | 18615 NE 174TH ST
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City | BRUSH PRAIRIE
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State | WA
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Zip | 98606-8733
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Country | US
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Telephone | 360-892-6189
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | WA MD00027001
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | OR MD16429
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License Number State | OR
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