Provider Demographics
NPI:1942963061
Name:RUANO-MORENO, MIQUEL ANGEL (BS)
Entity Type:Individual
Prefix:
First Name:MIQUEL
Middle Name:ANGEL
Last Name:RUANO-MORENO
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2992 NE MODA WAY APT 514
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7120
Mailing Address - Country:US
Mailing Address - Phone:925-595-6304
Mailing Address - Fax:
Practice Address - Street 1:2992 NE MODA WAY APT 514
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7120
Practice Address - Country:US
Practice Address - Phone:925-595-6304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer