Provider Demographics
NPI:1477732618
Name:RONALD S. GERNE DC PS
Entity Type:Organization
Organization Name:RONALD S. GERNE DC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:GERNE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:360-225-8314
Mailing Address - Street 1:1044 B ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-9404
Mailing Address - Country:US
Mailing Address - Phone:360-225-8314
Mailing Address - Fax:360-225-6361
Practice Address - Street 1:1044 B ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-9404
Practice Address - Country:US
Practice Address - Phone:360-225-8314
Practice Address - Fax:360-225-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2028702Medicaid
WAGAB07025Medicare PIN