Organization
LACEY MEDICAL CLINIC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD CHARLES KRAUSS MD (PRESIDENT)
(360) 438-0394
Entity
Organization
Contact information
Practice address
5602 RUDDELL RD SE, LACEY, WA 98503
(360) 438-0394
(360) 493-0824
Mailing address
5602 RUDDELL RD SE, LACEY, WA 98503
(360) 438-0394
(360) 493-0824
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7069750
—
WA
Enumeration date
09/07/2006
Last updated
06/23/2014
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