Marissa Rudolph, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60758338 Issued in WA

Practice address

9600 Veterans Dr SW
Tacoma, WA 98493-0003

Phone

(800) 329-8387

NPI assigned

Jun 30, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649462400000",
    "number": "1255782272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DR SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984930003",
            "telephone_number": "800-329-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DR SW",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984930003",
            "telephone_number": "800-329-8387"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 Veterans Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765047451",
            "country_code": "US",
            "telephone_number": "254-778-4811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Veterans Dr",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554172309",
            "country_code": "US",
            "telephone_number": "612-725-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "MARISSA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-30",
        "last_updated": "2022-04-09",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60758338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lynn Rucker
• Jon Leslie Ruckle, M.D.
• Amanda Starr Rudisill, AAC, CPC
• Rachel Renee Rudnick
• Jenna Lynn Rudnitskas
• Florida J Rue, RNFA
• Forrest L Rue, MD
• Kirk Rue, MD
• Heather Renee Rueb
• Nathalie Ruelas, MSW, LICSW

• Clinical Psychologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.