| Robert Fasman Phd Pllc | |
|
717 Ne 61st St Ste 202 Vancouver WA 98665-8756 | |
| (360) 450-0140 | |
| Not Available |
| Full Name | Robert Fasman Phd Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 717 Ne 61st St Ste 202, Vancouver, Washington |
| Authorized Official Name and Position | Robert Fasman (OWNER) |
| Authorized Official Contact | 3604500140 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Fasman Phd Pllc 717 Ne 61st St Ste 202 Vancouver WA 98665-8756 Ph: (360) 450-0140 | Robert Fasman Phd Pllc 717 Ne 61st St Ste 202 Vancouver WA 98665-8756 Ph: (360) 450-0140 |
| NPI Number | 1154954261 |
|---|---|
| Provider Enumeration Date | 02/17/2020 |
| Last Update Date | 02/17/2020 |
| Certification Date | 02/17/2020 |
| Medicare PECOS PAC ID | 9335578764 |
|---|---|
| Medicare Enrollment ID | O20200406000646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154954261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Robert Fasman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184973810 PECOS PAC ID: 4486806742 Enrollment ID: I20121212000584 |
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