Provider Demographics
NPI:1871668442
Name:LINDBERG, ROBERT PAUL (MSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PAUL
Last Name:LINDBERG
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 SE 164TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-8944
Mailing Address - Country:US
Mailing Address - Phone:360-896-6944
Mailing Address - Fax:360-254-2894
Practice Address - Street 1:417 SE 164TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-8944
Practice Address - Country:US
Practice Address - Phone:360-896-6944
Practice Address - Fax:360-254-2894
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI36-1231041C0700X
WALW605960821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical