Provider Demographics
NPI:1982899274
Name:FALLARME, RONALD PADLAN (PAC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:PADLAN
Last Name:FALLARME
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74B CENTENNIAL LOOP STE 300
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7925
Mailing Address - Country:US
Mailing Address - Phone:541-686-3791
Mailing Address - Fax:
Practice Address - Street 1:74B CENTENNIAL LOOP STE 300
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7925
Practice Address - Country:US
Practice Address - Phone:541-686-3791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19264363AS0400X
WAPA10005239363AS0400X
ORPA205403363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical