Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 5534 | WA |
NPI | 1003997446 |
---|---|
Provider Name | Dr. Ronald Jeffrey Trepanier |
First Address | Seattle, WA 98109-3096 |
Second Address | Seattle, WA 98109-3095 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |