Provider Demographics
NPI:1801910153
Name:CLAIRE SMITH RONEY, PH.D., INC., PC
Entity type:Organization
Organization Name:CLAIRE SMITH RONEY, PH.D., INC., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:RONEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:360-379-6259
Mailing Address - Street 1:PO BOX 1611
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-0110
Mailing Address - Country:US
Mailing Address - Phone:360-379-6259
Mailing Address - Fax:360-385-3058
Practice Address - Street 1:905 HIDDEN TRAIL RD
Practice Address - Street 2:
Practice Address - City:PORT TOWNSEND
Practice Address - State:WA
Practice Address - Zip Code:98368-9602
Practice Address - Country:US
Practice Address - Phone:360-379-6259
Practice Address - Fax:360-385-3058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY0001864261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
R94356Medicare UPIN
WA8802266Medicare ID - Type Unspecified