Provider Demographics
NPI:1043291438
Name:GATES, ROBERT G (PA-C)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:G
Last Name:GATES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4104 W HENRY ST
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-2908
Mailing Address - Country:US
Mailing Address - Phone:509-545-5227
Mailing Address - Fax:
Practice Address - Street 1:1979 SNYDER ST
Practice Address - Street 2:SUITE 150
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-5319
Practice Address - Country:US
Practice Address - Phone:509-376-6853
Practice Address - Fax:509-372-0522
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10003275363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical