Provider Demographics
NPI:1740892884
Name:RAMIREZ, GERARDO A SR (MC8584)
Entity type:Individual
Prefix:MR
First Name:GERARDO
Middle Name:A
Last Name:RAMIREZ
Suffix:SR
Gender:M
Credentials:MC8584
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:WA
Mailing Address - Zip Code:98579-0934
Mailing Address - Country:US
Mailing Address - Phone:360-481-6695
Mailing Address - Fax:360-237-3177
Practice Address - Street 1:6712 198TH AVE SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:WA
Practice Address - Zip Code:98579-9392
Practice Address - Country:US
Practice Address - Phone:360-481-6695
Practice Address - Fax:360-237-3177
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC8584171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter