Organization
ROBERT QUACKENBUSH MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C QUACKENBUSH MD (MD)
(509) 525-2220
Entity
Organization
Contact information
Practice address
40L W POPLAR ST, WALLA WALLA, WA 99362
(509) 525-2220
Mailing address
PO BOX 2102, WALLA WALLA, WA 99362-0102
(509) 525-2220
(509) 525-4878
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00039975
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA4111
RRMC
WA
Enumeration date
08/31/2007
Last updated
01/28/2008
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