Provider Demographics
NPI:1457479529
Name:RONALD O. ACOSTA, D.C. PLLC
Entity Type:Organization
Organization Name:RONALD O. ACOSTA, D.C. PLLC
Other - Org Name:HARMONY HEALTH CHIROPRACTIC & MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:OVIDIO
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:253-840-1100
Mailing Address - Street 1:2809 MERIDIAN AVE E
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98371-2108
Mailing Address - Country:US
Mailing Address - Phone:253-840-1100
Mailing Address - Fax:253-840-1199
Practice Address - Street 1:2809 MERIDIAN AVE E
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98371-2108
Practice Address - Country:US
Practice Address - Phone:253-840-1100
Practice Address - Fax:253-840-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH003629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU72611Medicare UPIN
WAAB33212Medicare ID - Type Unspecified