Individual
RONALD FLORES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
153 JOHNS CT, SHELTON, WA 98584-8225
(360) 427-2575
Mailing address
1707 SE MASON ST APT A, SHELTON, WA 98584-1668
(818) 317-5064
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P1.61353482
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WDL7Z849523B
DRIVERS LICENSE
WA
Enumeration date
01/23/2023
Last updated
01/23/2023
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