Individual
DR. MANDY DEANN ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 LILLY RD NE, OLYMPIA, WA 98506-5115
(360) 923-7000
(360) 923-7089
Mailing address
57 PUGET DR, STEILACOOM, WA 98388-1526
(509) 293-3259
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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