Individual
MR. ROBERT GENE LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
1899 -116TH AVE NE, BELLEVUE, WA 98004
(425) 451-0404
(425) 462-8919
Mailing address
7805 192ND PL SW, EDMONDS, WA 98026-6122
(425) 778-0976
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA00017176
WA
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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