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Individual

DR. MANDY DEANN ROBERTSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
MD00040630
WA
207RH0003X
Hematology & Oncology Physician
C143490
CA
207RX0202X
Medical Oncology Physician
Primary
MD00040630
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0228485
L&I
WA
05
1790730174
CA
05
1790730174
WA
01
315360
L&I POST 7/21/13
WA
01
P01257375
RR MEDICARE
WA
Enumeration date
05/23/2006
Last updated
10/03/2024
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