Healthcare Provider Details

I. General information

NPI: 1528288008
Provider Name (Legal Business Name): RONALD E. HARMON, D.D.S., P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 S UNION AVE STE C22
TACOMA WA
98405-1334
US

IV. Provider business mailing address

2302 S UNION AVE STE C22
TACOMA WA
98405-1334
US

V. Phone/Fax

Practice location:
  • Phone: 253-752-6336
  • Fax: 253-752-5655
Mailing address:
  • Phone: 253-752-6336
  • Fax: 253-752-5655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDE00003193
License Number StateWA

VIII. Authorized Official

Name: RONALD E HARMON
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 253-752-6336