Basic Information
| Provider Information | |||||||||
| NPI: | 1104013259 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBB | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 140 SOUTH HOLLY STREET | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417748200 | ||||||||
| FaxNumber: | 5417747964 | ||||||||
| Practice Location | |||||||||
| Address1: | 38872 PROCTOR BLVD | ||||||||
| Address2: | |||||||||
| City: | SANDY | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970558035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5037226950 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2007 | ||||||||
| LastUpdateDate: | 09/20/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCSW 3436 | HI | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | L5986 | OR | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.