Provider Demographics
NPI:1386888410
Name:LOCH, RONALD F JR (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:F
Last Name:LOCH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 33RD AVE W
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4746
Mailing Address - Country:US
Mailing Address - Phone:425-563-1500
Mailing Address - Fax:425-563-1374
Practice Address - Street 1:19020 33RD AVE W
Practice Address - Street 2:SUITE 210
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4746
Practice Address - Country:US
Practice Address - Phone:425-563-1500
Practice Address - Fax:425-563-1501
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD605513242085R0202X
ORMD1731022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2044437Medicaid
OR500690727Medicaid
WAG8954091Medicare PIN
WAP01689440Medicare PIN
WAG8954086Medicare PIN
WAG8954087Medicare PIN
WAP01689385Medicare PIN
WA2044437Medicaid
WAG8941135Medicare PIN
WAP01689412Medicare PIN
WAG8941133Medicare PIN
WAG8941132Medicare PIN
OR500690727Medicaid
WAG8941134Medicare PIN