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General NPI Number Information
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NPI Number | 1083952220
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Entity Type | Organization
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Legal Business Name | RONALD A KRUEGER MD INC PS
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 828 2ND ST STE C
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City | MUKILTEO
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State | WA
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Zip | 98275-1601
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Country | US
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Telephone | 425-341-4305
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Fax | 888-349-7131
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Provider Business Mailing Address
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Address Line | 828 2ND ST STE C
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City | MUKILTEO
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State | WA
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Zip | 98275-1601
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Country | US
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Telephone | 425-341-4305
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KELLY A KRUEGER
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Credential |
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Telephone | 425-341-4305
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 32364
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License Number State | WA
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