Provider Demographics
NPI:1316975824
Name:SLOAN, ROBERT STEVEN (PT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:STEVEN
Last Name:SLOAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 NW GILMAN BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5340
Mailing Address - Country:US
Mailing Address - Phone:425-391-9211
Mailing Address - Fax:425-391-9545
Practice Address - Street 1:1660 NW GILMAN BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5340
Practice Address - Country:US
Practice Address - Phone:425-391-9211
Practice Address - Fax:425-391-9545
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8448888Medicaid
WAAB16809Medicare ID - Type Unspecified