Healthcare Provider Details

I. General information

NPI: 1912310137
Provider Name (Legal Business Name): MR. RONALD FRANK BRIDGES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 PALMER DR
KALISPELL MT
59901-2769
US

IV. Provider business mailing address

167 PALMER DR
KALISPELL MT
59901-2769
US

V. Phone/Fax

Practice location:
  • Phone: 406-250-3474
  • Fax:
Mailing address:
  • Phone: 530-227-7737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number50740
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number79596
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number8327
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: