Provider Demographics
NPI:1386824894
Name:JAMES A ROUBOS PHD PS
Entity type:Organization
Organization Name:JAMES A ROUBOS PHD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROUBOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:509-624-2621
Mailing Address - Street 1:922 S COWLEY ST STE 6
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1263
Mailing Address - Country:US
Mailing Address - Phone:509-624-2621
Mailing Address - Fax:509-624-6396
Practice Address - Street 1:922 S COWLEY ST STE 6
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1263
Practice Address - Country:US
Practice Address - Phone:509-624-2621
Practice Address - Fax:509-624-6396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001015261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)