PRESTON WILSON ROBERTS (NPI# 1376787036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376787036 |
| Entity Type | Individual |
| Full Name | PRESTON WILSON ROBERTS |
| Credential | M.D. |
| Practice Address |
9040 Jackson Ave Tacoma WA 98431-1000 |
| Mailing Address |
9040 Fitzsimmons Dr Joint Base Lewis Mcchord WA 98431-1000 |
| Practice Telephone | 2539685064 |
| Mailing Telephone | 2539685064 |
| Enumeration Date | 2009-04-26 |
| Last Update Date | 2019-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 25884 | NE | Allopathic & Osteopathic Physicians |
| Street Address |
9040 JACKSON AVE |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-1000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356345185 | John E Buonora | Nurse Anesthetist, Certified Registered | 9040 Jackson Ave, Tacoma, WA 98431-2025 | 2005-06-09 |
| 1629675251 | Brian Rankin | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-10-06 |
| 1508473869 | Allyssa Lynn Borak | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-09-30 |
| 1093322299 | Jessica Granger | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-09-30 |
| 1134736481 | Rebecca Reinhardt | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-09-29 |
| 1184238479 | Mark Nash | Physical Therapist | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-09-03 |
| 1679191969 | Christopher A Land | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-07-13 |
| 1396362604 | Valerie Kruger | Genetic Counselor, MS | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-07-02 |
| 1255958724 | Michael Wong | Student in an Organized Health Care Education/Training Program | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-07-01 |
| 1841813391 | Kailey Utley | Optometrist | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2020-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255896601 | Emily Christine Buck | General Practice | 940 Fitzsimmons Dr, Tacoma, WA 98431-0001 | 2019-02-08 |
| 1457708430 | James Bailey | General Practice | 9040 Jackson Ave Tripler Army Medical Center, Tacoma, WA 98431-5001 | 2016-05-19 |
| 1841553740 | Nevine F N Makari | General Practice | 6909 Bridgland Ln, Tacoma, WA 98407-1020 | 2012-06-17 |
| 1952637332 | Proctor Medical Clinic | General Practice | 1208 South Proctor St, Tacoma, WA 98405 | 2009-10-20 |
| 1194050773 | K and A Diagnostic Center | General Practice | 1206 South Proctor St, Tacoma, WA 98405 | 2009-10-15 |
| 1811915374 | Dung Xuan Nguyen | General Practice | 3736 S G St, Tacoma, WA 98418-6725 | 2006-07-17 |
| 1770514937 | Spanaway General Medical Clinic | General Practice | 15005 Pacific Ave, Spanaway General Medical Clinic, Tacoma, WA 98444 | 2006-07-06 |
| 1710936208 | Jane Ann Moore | General Practice | 6002 Westgate Blvd, Suite 160, Tacoma, WA 98406-2571 | 2006-05-10 |
| 1295716884 | Thu Van Le | General Practice | 1212 S 11th St, Suite 39, Tacoma, WA 98405-4021 | 2005-11-10 |
| 1841750536 | Clayton Andrew Harris | General Practice | 9040 Jackson Ave, Tacoma, WA 98431-0001 | 2019-03-20 |
| Find all providers in TACOMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.