Provider Demographics
NPI:1235105719
Name:KRAUSS, RONALD CHARLES (MD)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:CHARLES
Last Name:KRAUSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 RUDDELL RD SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503
Mailing Address - Country:US
Mailing Address - Phone:360-438-0394
Mailing Address - Fax:360-493-0824
Practice Address - Street 1:5602 RUDDELL RD SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503
Practice Address - Country:US
Practice Address - Phone:360-438-0394
Practice Address - Fax:360-493-0824
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00016382207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1300359Medicaid
WA1300359Medicaid