Provider Demographics
NPI:1912154105
Name:ROBINS, MARK ELLIOT (DPT)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ELLIOT
Last Name:ROBINS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30224
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98228-2224
Mailing Address - Country:US
Mailing Address - Phone:360-201-2525
Mailing Address - Fax:
Practice Address - Street 1:2075 BARKLEY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6614
Practice Address - Country:US
Practice Address - Phone:360-733-4008
Practice Address - Fax:360-733-4064
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60017696225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist