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NPI Code Detail

MEDICARE: MR. ROBERT J. CAPOVILLA MA

MEDICARE:  MR. ROBERT J. CAPOVILLA  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLH00006587WA

General Provider Information

NPI Number : 1902952427
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT J. CAPOVILLA MA
Provider Business Mailing Address
First Line : 4505 44TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98116-4116
Country : US
Telephone Number : 206-932-2393
Fax Number :
Provider Business Practice Location Address
First Line : 4505 44TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98116-4116
Country : US
Telephone Number : 206-932-2393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 07/08/2007

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Directions to “ MR. ROBERT J. CAPOVILLA MA” Practice Location

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