Provider Demographics
NPI:1881792455
Name:RONAN, JAMES PATRICK (ARNP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PATRICK
Last Name:RONAN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1582 GULF RD UNIT 1309
Mailing Address - Street 2:
Mailing Address - City:POINT ROBERTS
Mailing Address - State:WA
Mailing Address - Zip Code:98281-8059
Mailing Address - Country:US
Mailing Address - Phone:503-449-0293
Mailing Address - Fax:503-449-0293
Practice Address - Street 1:9951 MICKELBERRY RD NW STE 101
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8309
Practice Address - Country:US
Practice Address - Phone:360-692-9362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR088006164N2 PNP-PP363LP0200X
AZRN091542 182363LP0200X
WAAP60076323363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1881792455Medicaid
WA263676OtherLABOR & INDUSTRIES
OR292795OtherOMAP
AZ373481OtherAHCCCS
OR292795OtherOMAP
AZ373481OtherAHCCCS