Provider Demographics
NPI:1386928216
Name:CRAIG A RONE MD PS
Entity type:Organization
Organization Name:CRAIG A RONE MD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:A
Authorized Official - Last Name:RONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-272-7114
Mailing Address - Street 1:316 MARTIN LUTHER KING JR WAY
Mailing Address - Street 2:#305
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4252
Mailing Address - Country:US
Mailing Address - Phone:253-272-7114
Mailing Address - Fax:
Practice Address - Street 1:316 MARTIN LUTHER KING JR WAY
Practice Address - Street 2:# 305
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4252
Practice Address - Country:US
Practice Address - Phone:253-272-7114
Practice Address - Fax:253-272-4765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-11
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00016737207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty