Provider Demographics
NPI:1871899385
Name:HILLMAN, RON WAYNE JR (MA, MHP)
Entity type:Individual
Prefix:MR
First Name:RON
Middle Name:WAYNE
Last Name:HILLMAN
Suffix:JR
Gender:M
Credentials:MA, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20835 60TH ST E
Mailing Address - Street 2:
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-8629
Mailing Address - Country:US
Mailing Address - Phone:206-349-4371
Mailing Address - Fax:
Practice Address - Street 1:17220 127TH PL NE
Practice Address - Street 2:SUITE 101B
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-7965
Practice Address - Country:US
Practice Address - Phone:206-349-4371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60238865101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor