Active NPI
Ruby Medina, MSW
- Clinical Social Worker
- Grandview, WA
National Provider Identifier
1043711252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SC60426069
- Practice address
- 208 N. Euclid
Grandview, WA 98930 - Phone
- (509) 882-1855
- Fax
- (509) 882-4998
- NPI assigned
- Feb 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SC60426069 | WA | Primary |
Addresses
Primary practice location
208 N. Euclid
Grandview, WA 98930
Mailing address
1905 Queen Street
Grandview, WA 98930
Phone (509) 305-3851
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC60426069 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519257600000",
"number": "1043711252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1905 QUEEN STREET",
"city": "GRANDVIEW",
"state": "WA",
"postal_code": "98930",
"telephone_number": "509-305-3851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 N. EUCLID",
"city": "GRANDVIEW",
"state": "WA",
"postal_code": "98930",
"telephone_number": "509-882-1855",
"fax_number": "509-882-4998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "RUBY",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2018-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "SC60426069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grandview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.