Provider Demographics
NPI:1861898199
Name:WARE, ROBIN (LAT, ATC, CSCS)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:WARE
Suffix:
Gender:F
Credentials:LAT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 M ST NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4591
Mailing Address - Country:US
Mailing Address - Phone:253-833-8766
Mailing Address - Fax:
Practice Address - Street 1:701 M ST NE
Practice Address - Street 2:SUITE 102
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4591
Practice Address - Country:US
Practice Address - Phone:253-833-8766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1 602340452255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer