RONNI WALTZ (NPI# 1144785064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144785064 |
| Entity Type | Individual |
| Full Name | RONNI WALTZ |
| Credential | PSS |
| Practice Address |
155 S Empire Blvd Coos Bay OR 97420 |
| Mailing Address |
1942 Sheridan Ave North Bend OR 97459-3416 |
| Practice Telephone | 5417563111 |
| Practice Fax Number | 5417562111 |
| Mailing Telephone | 5417563111 |
| Mailing Fax Number | 5417562111 |
| Enumeration Date | 2019-02-05 |
| Last Update Date | 2019-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | THW000003325 | OR | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1942 Sheridan Ave, North Bend, OR 974593416 | 5417563111 | 5417562111 |
| Street Address |
155 S EMPIRE BLVD |
| City | COOS BAY |
| State | OR |
| Zip Code | 97420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467856922 | Carolyn Louise Billman | Counselor | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2014-10-13 |
| 1215550934 | Tabetha Lynn Evernden | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-05-28 |
| 1154944346 | Andrea Gross | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-05-21 |
| 1013536986 | William Todd Stone | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-04-10 |
| 1003445875 | Sarah Susan Tucker | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-04-03 |
| 1376174003 | Joshua Jay Haynes | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-01-31 |
| 1730743535 | Paul Gonzales | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2019-04-26 |
| 1396201216 | Anthony L Wilson | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2019-02-15 |
| 1245795095 | Diana Julianne Collins | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2019-02-06 |
| 1114499324 | Tasha Anne Walter | Counselor | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2018-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880606 | Danielle Goette | Massage Therapist | 320 Central Ave Suite 226, Coos Bay, OR 97420 | 2020-01-14 |
| 1730643735 | Nicole Hand-therapeutic Massage | Massage Therapist | 3229 Broadway Avenue, Suite D, Coos Bay, OR 97420 | 2019-01-24 |
| 1528531100 | A Better Reality | Clinic/Center | 2690 N. 17th Sstreet, Coos Bay, OR 97420 | 2019-01-07 |
| 1396216883 | Elizabeth Rose Stephens | Health Educator | 97381 Newport Lane, Coos Bay, OR 97420 | 2018-12-10 |
| 1093263386 | Megan Smith | Physician Assistant | 375 Park Ave Ste 5, Coos Bay, OR 97420 | 2016-09-14 |
| 1285091884 | Richard T Rigney | Counselor | 62754 Karl Road, Coos Bay, OR 97420 | 2016-01-27 |
| 1821493032 | James Thomas Agee | Pharmacist | 2051 Newmark Avenue, Walmart Pharmacy 1880, Coos Bay, OR 97420 | 2014-10-30 |
| 1346663895 | Steven D. Richardson D.m.d. L.l.c | Dentist | 1835 Ocean Blvd Se, Coos Bay, OR 97420 | 2014-02-03 |
| 1144669243 | Michael Jason Cole | Pharmacist | 1020 South First Ave, Coos Bay, OR 97420 | 2013-06-21 |
| 1639518053 | Jonathan Thomas Small | Physical Therapist | 2645 North 17th St, Coos Bay, OR 97420 | 2013-06-19 |
| Find all providers in zip 97420 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550934 | Tabetha Lynn Evernden | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-05-28 |
| 1154944346 | Andrea Gross | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-05-21 |
| 1013536986 | William Todd Stone | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-04-10 |
| 1003445875 | Sarah Susan Tucker | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-04-03 |
| 1881229797 | Kelli Woods | Peer Specialist | 2020 Thompson Rd, Coos Bay, OR 97420-2041 | 2020-03-11 |
| 1477188399 | Dorannlyn Mills | Peer Specialist | 2020 Thompson Rd, Coos Bay, OR 97420-2041 | 2020-03-11 |
| 1376174003 | Joshua Jay Haynes | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2020-01-31 |
| 1114560802 | Jesse C Staubach | Peer Specialist | 320 Central Ave Ste 304, Coos Bay, OR 97420-2241 | 2019-10-24 |
| 1730743535 | Paul Gonzales | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2019-04-26 |
| 1396201216 | Anthony L Wilson | Peer Specialist | 155 S Empire Blvd, Coos Bay, OR 97420-3374 | 2019-02-15 |
| Find all providers in COOS BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.