=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649226374
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RONALD PHILIP DELANO O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2006
-----------------------------------------------------
Last Update Date | 01/25/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 E CHESTNUT AVE
-----------------------------------------------------
City | YAKIMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98901-2174
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-457-9219
-----------------------------------------------------
Fax | 509-576-4375
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 621 S 68TH AVE
-----------------------------------------------------
City | YAKIMA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98908-1802
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-966-1628
-----------------------------------------------------
Fax | 509-453-6248
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152WC0802X
-----------------------------------------------------
Taxonomy Name | Corneal and Contact Management Optometrist
-----------------------------------------------------
License Number | OD00001475
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 152WL0500X
-----------------------------------------------------
Taxonomy Name | Low Vision Rehabilitation Optometrist
-----------------------------------------------------
License Number | OD00001475
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 152WP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Optometrist
-----------------------------------------------------
License Number | OD00001475
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------