MR. Robert Wayne Long, CDP
NPI #1508908880 in Bonney Lake, Washington
Provider Information
- NPI Number
- 1508908880
- Entity Type
- Individual
- Name
- MR. Robert Wayne Long, CDP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist
- Credential
- CDP
- Enumeration Date
- Feb 13, 2007
- Last Updated
- Feb 28, 2013
Practice Location
- Address
- 10215 214TH AVE E
- City
- Bonney Lake
- State
- Washington
- ZIP Code
- 98391-3909
- Phone
- (253) 862-7374
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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