Provider Demographics
NPI:1285697573
Name:ROBACHINSKI, CHESTER MARK (MD)
Entity type:Individual
Prefix:
First Name:CHESTER
Middle Name:MARK
Last Name:ROBACHINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4410
Mailing Address - Country:US
Mailing Address - Phone:206-328-8216
Mailing Address - Fax:206-726-1878
Practice Address - Street 1:818 12TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4410
Practice Address - Country:US
Practice Address - Phone:206-328-8216
Practice Address - Fax:206-726-1878
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000273302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAFO2860Medicare UPIN