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Individual

ROBERT R. LESSARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
307 S. 13TH STREET, SUITE 300, MOUNT VERNON, WA 98274
(360) 336-9757
(360) 814-5237
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0250 P
NH
363A00000X
Physician Assistant
PA60633795
WA
363AM0700X
Medical Physician Assistant
Primary
PA60633795
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30009541
NH
Enumeration date
05/17/2007
Last updated
05/19/2016
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