Provider Demographics
NPI:1972713527
Name:COULSON, RONALD H (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:H
Last Name:COULSON
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 1:448 SUSSEX AVE E. TENINO CHIROPRACTIC POBOX 676
Mailing Address - Street 2:PO BOX 676
Mailing Address - City:TENINO
Mailing Address - State:WA
Mailing Address - Zip Code:98589
Mailing Address - Country:US
Mailing Address - Phone:360-264-5999
Mailing Address - Fax:360-264-5979
Practice Address - Street 1:448 SUSSEX AVE E
Practice Address - Street 2:SUITE 3 BOX 676
Practice Address - City:TENINO
Practice Address - State:WA
Practice Address - Zip Code:98589
Practice Address - Country:US
Practice Address - Phone:360-264-5999
Practice Address - Fax:360-264-5979
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001296111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor