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General NPI Number Information
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NPI Number | 1821645979
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Entity Type | Individual
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Provider Name | KYLE P ROBLES PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | PO BOX 421
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-0421
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Country | US
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Telephone | 509-293-5421
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Fax | 509-227-7070
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Provider Business Mailing Address
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Address Line | PO BOX 421
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-0421
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Country | US
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Telephone | 509-489-3554
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Fax | 509-227-7070
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA61281714
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License Number State | WA
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