Individual
ROBERT W LANDERHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19930 BALLINGER WAY NE, SHORELINE, WA 98155
(425) 778-2220
Mailing address
19930 BALLINGER WAY NE, SHORELINE, WA 98155-1223
(425) 778-2220
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00026505
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD00026505
STATE LICENSE
WA
Enumeration date
07/26/2006
Last updated
08/23/2018
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