Healthcare Provider Details

I. General information

NPI: 1225078827
Provider Name (Legal Business Name): RONALD SPIEGEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LILLY RD NE
OLYMPIA WA
98506-5115
US

IV. Provider business mailing address

9801 FRONTIER AVE SE
SNOQUALMIE WA
98065-5200
US

V. Phone/Fax

Practice location:
  • Phone: 360-923-7000
  • Fax: 360-923-7089
Mailing address:
  • Phone: 425-831-2300
  • Fax: 425-831-2361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD00041088
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: