Basic Information
| Provider Information | |||||||||
| NPI: | 1255529665 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOPES | ||||||||
| FirstName: | RONALD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.A., CDP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1115 SE 164TH AVE | ||||||||
| Address2: | DEPT 358 | ||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986839324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607886565 | ||||||||
| FaxNumber: | 3607156567 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 E CHESTNUT ST STE 3E | ||||||||
| Address2: | |||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982255241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607886565 | ||||||||
| FaxNumber: | 3607156567 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2007 | ||||||||
| LastUpdateDate: | 06/17/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | RC00043141 | WA | N | Behavioral Health & Social Service Providers | Counselor | 101YA0400X | CP00006432 | WA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | CP00006432 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.