Basic Information
Provider Information
NPI: 1528162740
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBON
FirstName: MATTHEW
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 805 MADISON ST
Address2: SUITE 901
City: SEATTLE
State: WA
PostalCode: 981041172
CountryCode: US
TelephoneNumber: 2062648100
FaxNumber: 2062648689
Practice Location
Address1: 1231 116TH AVE NE
Address2: SUITE 750
City: BELLEVUE
State: WA
PostalCode: 980043804
CountryCode: US
TelephoneNumber: 4254553600
FaxNumber: 4254553920
Other Information
ProviderEnumerationDate: 09/08/2006
LastUpdateDate: 05/15/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0106XMD00047476WAN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
2086S0105XMD00047476WAN Allopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
207X00000XMD00047476WAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
208600000XMD00047476WAN Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
022403401WAL & IOTHER
G887664501WAMEDICARE EMRIOTHER
P0068898101WAMEDICARE RR KING CO.OTHER
G887173001WAMEDICARE POSMOTHER


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