Individual
GHISLAINE ROBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8630 164TH AVE NE, 205, REDMOND, WA 98052-3606
(425) 836-1800
(425) 836-1877
Mailing address
8630 164TH AVE NE, 205, REDMOND, WA 98052-3606
(425) 836-1800
(425) 836-1877
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MD00042487
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039594
LABOR & INDUSTRY
WA
01
—
5576RO
BLUE SHIELD
WA
05
—
8390775
—
WA
01
—
US7933591
AETNA/USHC SPECIALIST
WA
Enumeration date
07/13/2006
Last updated
03/12/2015
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