Individual
ROBERT W GANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARPN
Contact information
Practice address
1802 YAKIMA AVE STE 204, TACOMA, WA 98405-5304
(253) 382-8540
(253) 382-8545
Mailing address
1802 YAKIMA AVE STE 204, TACOMA, WA 98405-5304
(253) 382-8540
(253) 382-8545
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
110790
NE
363L00000X
Nurse Practitioner
AP60292404
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
AP60292404
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200632670A
—
KS
05
—
2020584
—
WA
01
—
38767
BCBS
NE
Enumeration date
07/27/2006
Last updated
09/27/2024
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