Individual
DR. RAMON ROLAND ISIDRO BASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-4972
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-4972
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.012226
OH
207R00000X
Internal Medicine Physician
Primary
MD 60071840
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0252819
STATE L&I
WA
01
—
P00830970
RAILROAD
WA
Enumeration date
04/28/2009
Last updated
12/13/2010
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