Provider Demographics
NPI:1215933890
Name:SMALL, ROBERT H (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:SMALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1517
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98009-1517
Mailing Address - Country:US
Mailing Address - Phone:206-286-4421
Mailing Address - Fax:
Practice Address - Street 1:7001 220TH STREET S.W.
Practice Address - Street 2:MAILSTOP 445
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2124
Practice Address - Country:US
Practice Address - Phone:425-918-4573
Practice Address - Fax:425-918-4270
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD000239492084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry