Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DE00003193 | WA |
NPI | 1043430580 |
---|---|
Provider Name | Ronald E Harmon |
First Address | Tacoma, WA 98405-1334 |
Second Address | Tacoma, WA 98405-1334 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 08/07/2007 |