Provider Demographics
NPI:1699196451
Name:FERRIANS, RONALD DAMON (LMT)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:DAMON
Last Name:FERRIANS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16606 48TH AVE W APT B203
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-6854
Mailing Address - Country:US
Mailing Address - Phone:206-214-6883
Mailing Address - Fax:
Practice Address - Street 1:930 S 336TH ST
Practice Address - Street 2:#E
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6384
Practice Address - Country:US
Practice Address - Phone:253-252-2415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-21
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 00022478225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist