Provider Demographics
NPI:1629198122
Name:HSU, RONALD HSIEN-JUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:HSIEN-JUNG
Last Name:HSU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2115 SE 192ND AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7444
Mailing Address - Country:US
Mailing Address - Phone:360-216-1130
Mailing Address - Fax:360-216-1125
Practice Address - Street 1:2115 SE 192ND AVE STE 106
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7444
Practice Address - Country:US
Practice Address - Phone:360-216-1130
Practice Address - Fax:360-216-1125
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAD101721223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry