Provider Demographics
NPI:1831475219
Name:SWANSON, RONALD EUGENE (RPH)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:EUGENE
Last Name:SWANSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4299 GUIDE MERIDIAN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-6475
Mailing Address - Country:US
Mailing Address - Phone:360-738-7851
Mailing Address - Fax:
Practice Address - Street 1:4299 GUIDE MERIDIAN
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6475
Practice Address - Country:US
Practice Address - Phone:360-738-7851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7205183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist