Individual
ROBERT C QUACKENBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 W POPLAR ST, WALLA WALLA, WA 99362-2846
(509) 522-5700
(509) 522-5705
Mailing address
PO BOX 32, LIBERTY LAKE, WA 99019-0032
(509) 522-5700
(509) 522-5705
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD00039975
WA
207RX0202X
Medical Oncology Physician
Primary
MD00039975
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1118421
—
WA
05
—
227516
—
OR
05
—
8060599
—
ID
01
—
P00057996
RRMC
WA
Enumeration date
05/25/2006
Last updated
06/26/2013
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