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Individual

ROBERT R LIVINGSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1304 FAWCETT AVENUE, SUITE 200, TACOMA, WA 98402-1911
(253) 761-4200
(253) 383-3553
Mailing address
PO BOX 1535, TACOMA, WA 98401-1535
(253) 761-4200
(253) 383-3553

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
00016031
WA
2085R0202X
Diagnostic Radiology Physician
Primary
MD00D16031
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
119258
LABOR AND INDUSTRIES/WC UNION AVENUE OPEN
WA
01
300020214
RR MEDICARE TRA
WA
01
40719
LABOR AND INDUSTRIES/WC TRA
WA
05
8388506
WA
01
AB36539
MEDICARE PIN TRA KING COUNTY
WA
01
LI2582
REGENCE BLUE SHIELD TRA
WA
01
LI7252
REGENCE BLUE SHIELD UNION AVENUE OPEN
WA
Enumeration date
11/16/2006
Last updated
01/26/2010
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