Provider Demographics
NPI:1215100870
Name:DESAUTEL, ROBYN RACHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:RACHELLE
Last Name:DESAUTEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5902 CALIFORNIA AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1650
Mailing Address - Country:US
Mailing Address - Phone:206-932-3718
Mailing Address - Fax:206-937-6786
Practice Address - Street 1:5902 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1650
Practice Address - Country:US
Practice Address - Phone:206-932-3718
Practice Address - Fax:206-937-6786
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003010111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA601583642OtherUBI