Provider Demographics
NPI:1760451942
Name:ANDRADE, RONALD G (RPH)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:G
Last Name:ANDRADE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98363-1619
Mailing Address - Country:US
Mailing Address - Phone:360-457-6281
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL
Practice Address - Street 2:4375 N. SARATOGA STREET
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98278-0001
Practice Address - Country:US
Practice Address - Phone:360-257-9704
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA180731835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy