Basic Information
| Provider Information | |||||||||
| NPI: | 1598857104 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCMANUS | ||||||||
| FirstName: | ROBBIE | ||||||||
| MiddleName: | RAE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MS LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 897 JUNIPER PT LANE | ||||||||
| Address2: | |||||||||
| City: | CAMANO IS | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604193531 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1100 SOUTH SECOND ST | ||||||||
| Address2: | COMPASS NORTH | ||||||||
| City: | MT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604193500 | ||||||||
| FaxNumber: | 3604193535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | IH0003986 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.