Provider Demographics
NPI:1619024148
Name:EASTMAN, RONALD JAMES (MED LMHC CGP)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JAMES
Last Name:EASTMAN
Suffix:
Gender:M
Credentials:MED LMHC CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 14234
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99214-0234
Mailing Address - Country:US
Mailing Address - Phone:509-456-2190
Mailing Address - Fax:509-456-7371
Practice Address - Street 1:607 S GOVERNMENT WAY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-1860
Practice Address - Country:US
Practice Address - Phone:509-456-2190
Practice Address - Fax:509-456-7371
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004530101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health