Provider Demographics
NPI:1770765703
Name:YOUNG, RONDA K (BA)
Entity type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:K
Last Name:YOUNG
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8821 CUSTER RD SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2105
Mailing Address - Country:US
Mailing Address - Phone:253-584-3270
Mailing Address - Fax:
Practice Address - Street 1:8821 CUSTER RD SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2105
Practice Address - Country:US
Practice Address - Phone:253-584-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00035965101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor