Provider Demographics
NPI:1184066763
Name:ROBOTTOM, ANDREW MARK (RN)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:MARK
Last Name:ROBOTTOM
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16770 SW EDY RD STE 102B
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9679
Mailing Address - Country:US
Mailing Address - Phone:503-216-9600
Mailing Address - Fax:503-216-9650
Practice Address - Street 1:16770 SW EDY RD STE 102B
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9679
Practice Address - Country:US
Practice Address - Phone:503-216-9600
Practice Address - Fax:503-216-9650
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200843125RN163WP2201X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care