Provider Demographics
NPI:1306043310
Name:METCALF, RONDA KAY (COUNSELOR- REGISTERE)
Entity Type:Individual
Prefix:MS
First Name:RONDA
Middle Name:KAY
Last Name:METCALF
Suffix:
Gender:F
Credentials:COUNSELOR- REGISTERE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5318 CHIEF BROWN LN
Mailing Address - Street 2:
Mailing Address - City:DARRINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98241-9420
Mailing Address - Country:US
Mailing Address - Phone:360-436-1400
Mailing Address - Fax:360-436-0242
Practice Address - Street 1:5318 CHIEF BROWN LN
Practice Address - Street 2:
Practice Address - City:DARRINGTON
Practice Address - State:WA
Practice Address - Zip Code:98241-9420
Practice Address - Country:US
Practice Address - Phone:360-436-1400
Practice Address - Fax:360-436-0242
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00058101101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1981315Medicaid