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General NPI Number Information
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NPI Number | 1043102130
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Entity Type | Individual
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Provider Name | RONNIE S RODRIGUEZ CRM
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Gender | Female
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 1516 SW EMIGRANT AVE
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City | PENDLETON
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State | OR
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Zip | 97801-1838
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Country | US
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Telephone | 541-215-8798
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 882
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City | PENDLETON
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State | OR
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Zip | 97801-0882
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Country | US
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Telephone | 541-663-4104
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 24-CRM-3803
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License Number State | OR
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