Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1104178326 Deactivated / Inactive NPI Male Practitioner

Dr. Ronald T. Watanabe , DC, RPH

Chiropractor • Lakeside, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Ronald Watanabe has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 11, 2012
NPI Deactivation Date March 01, 2022
Total Practice Duration ~10 Years of Practice (2012 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Ronald Watanabe, DC, RPH was a registered Chiropractor practicing in Lakeside, AZ. Throughout an active medical career spanning 10 years, Dr. Watanabe provided care at the practice location at 20 WEST WHITE MOUNTAIN ROAD until profile deactivation on 2022-03-01.

Practice Location & Contact Primary Location

Practice Address

20 West White Mountain Road
Safeway Pharmacy

Lakeside, AZ 85929

Telephone 9283675442
Associated Practice Facility / Clinic
🏢 Safeway Inc Facility NPI 1972539757

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Lakeside, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 26.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Lakeside, AZ (2102 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License AZ 4364

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1609108786

Registered Pharmacist

NPI 1790335107
NPI 1962984252

Registered Pharmacist, Doctor of Pharmacy (Pharm.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 01, 2022

Record deactivated on March 01, 2022

NPI Profile Active October 11, 2012

NPI status registered as active in NPPES database

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Updated Practice Location October 11, 2012

Registered at 20 WEST WHITE MOUNTAIN ROAD, SAFEWAY PHARMACY, LAKESIDE, AZ 85929 (Tel: 9283675442)

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Updated Business Mailing Address October 11, 2012

Registered at PO BOX 3116, PINETOP, AZ 859353116 (Tel: 9823671099)

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Provider Name / Credentials Updated October 11, 2012

Recorded as RONALD WATANABE, DC, RPH

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 11, 2012

Chiropractor (License #4364 in AZ)

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Initial NPI Registration & Enumeration October 11, 2012

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104178326
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 11, 2012
Last Update: October 11, 2012
Deactivation Date: March 01, 2022

Mailing Address

Po Box 3116

Pinetop, AZ 859353116

Phone: 9823671099

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.