Provider Demographics
NPI:1811030471
Name:HILLERS, RONALD S (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:S
Last Name:HILLERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 WHEATON WAY STE N
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3566
Mailing Address - Country:US
Mailing Address - Phone:360-479-2144
Mailing Address - Fax:360-479-1957
Practice Address - Street 1:4020 WHEATON WAY STE N
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3566
Practice Address - Country:US
Practice Address - Phone:360-479-2144
Practice Address - Fax:360-479-1957
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB01358Medicare ID - Type Unspecified
WA601809503Medicare UPIN