Healthcare Provider Details

I. General information

NPI: 1386928216
Provider Name (Legal Business Name): CRAIG A RONE MD PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 MARTIN LUTHER KING JR WAY # 305
TACOMA WA
98405-4252
US

IV. Provider business mailing address

316 MARTIN LUTHER KING JR WAY #305
TACOMA WA
98405-4252
US

V. Phone/Fax

Practice location:
  • Phone: 253-272-7114
  • Fax: 253-272-4765
Mailing address:
  • Phone: 253-272-7114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number00016737
License Number StateWA

VIII. Authorized Official

Name: DR. CRAIG A RONE
Title or Position: OWNER
Credential: MD
Phone: 253-272-7114