Provider Demographics
NPI:1700822251
Name:RAMONA L. CALIVA DPM
Entity Type:Organization
Organization Name:RAMONA L. CALIVA DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CALIVA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:360-373-1772
Mailing Address - Street 1:1211 IVY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3511
Mailing Address - Country:US
Mailing Address - Phone:360-373-1772
Mailing Address - Fax:360-377-7151
Practice Address - Street 1:1211 IVY RD
Practice Address - Street 2:STE 100
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3511
Practice Address - Country:US
Practice Address - Phone:360-373-1772
Practice Address - Fax:360-377-7151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP 392213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
480006194OtherMEDICARE RAILROAD
WA1023910Medicaid
0006950OtherL&I
CA0650OtherREGENCE RIDER
CA0650OtherREGENCE RIDER
480006194OtherMEDICARE RAILROAD