Individual
MR. ROBERT C JANISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7012 NE 40TH ST, VANCOUVER, WA 98661-3052
(360) 254-5254
(360) 944-3835
Mailing address
2615 N 4TH ST STE 6, FLAGSTAFF, AZ 86004-1812
(928) 774-4761
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D7791
OR
1223G0001X
General Practice Dentistry
Primary
DE00009252
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158867
L&I
WA
05
—
5038989
—
WA
01
—
8932835
CRIME VICTIMS
WA
Enumeration date
08/29/2006
Last updated
09/01/2021
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