Provider Demographics
NPI:1215204243
Name:RONALD DELANO
Entity Type:Organization
Organization Name:RONALD DELANO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:DELANO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-576-3989
Mailing Address - Street 1:621 S 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-1802
Mailing Address - Country:US
Mailing Address - Phone:509-966-1628
Mailing Address - Fax:509-576-4375
Practice Address - Street 1:1600 E CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2174
Practice Address - Country:US
Practice Address - Phone:509-576-3989
Practice Address - Fax:509-576-4375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1475152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
212967OtherHUMANA
WA2033363Medicaid
WA1600DEOtherREGENCE BLUE SHIELD
212967OtherHUMANA
WA2033363Medicaid