Basic Information
| Provider Information | |||||||||
| NPI: | 1164628756 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EAGER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 34503 9TH AVE S STE 100 | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980038726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538358700 | ||||||||
| FaxNumber: | 2538358000 | ||||||||
| Practice Location | |||||||||
| Address1: | 34503 9TH AVE S STE 100 | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980038726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538358700 | ||||||||
| FaxNumber: | 2538358000 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 10/26/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MDR-5279 | HI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD60205862 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0281327 | 01 | WA | DEPT OF LABOR AND INDUSTRIES | OTHER | P00958040 | 01 | WA | RAILROAD MEDICARE | OTHER | 2012921 | 05 | WA | MEDICAID |