Provider Demographics
NPI:1881742476
Name:ADA, RONALD JAMES (L AC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:JAMES
Last Name:ADA
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2266
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-2266
Mailing Address - Country:US
Mailing Address - Phone:206-463-4342
Mailing Address - Fax:206-463-4342
Practice Address - Street 1:21830 VASHON HWY SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-6518
Practice Address - Country:US
Practice Address - Phone:206-463-4342
Practice Address - Fax:206-463-4342
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000264171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist