Basic Information
| Provider Information | |||||||||
| NPI: | 1679035067 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBISON | ||||||||
| FirstName: | CAITLYN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 929 109TH AVE NE | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980044404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253261545 | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 CORPORATE DR STE 110 | ||||||||
| Address2: | |||||||||
| City: | LADERA RANCH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926942107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9496616753 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2019 | ||||||||
| LastUpdateDate: | 08/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | WA | N | 106S00000X | Y |
No ID Information.