Individual provider Active NPI

Diane Marie Rulon, PHYSICAL THERAPY

  • Neurology Physical Therapist
  • Bremerton, WA
National Provider Identifier
1679772503
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology Physical TherapistTaxonomy code 2251N0400X
License
2015 Issued in WA
Practice address
140 S Marion Ave
Bremerton, WA 98312-3639
Phone
(360) 479-4747
Fax
(360) 478-6246
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physical Therapist 2251N0400X 2015 WA Primary

Addresses

Primary practice location

140 S Marion Ave
Bremerton, WA 98312-3639

Mailing address

140 S Marion Ave
Bremerton, WA 98312-3639
Phone (360) 479-4747

Other identifiers 1

IdentifierTypeStateIssuer
4111589MedicaidWA

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2015WAMDNeurology Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1679772503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S MARION AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983123639",
            "telephone_number": "360-479-4747",
            "fax_number": "360-478-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S MARION AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983123639",
            "telephone_number": "360-479-4747",
            "fax_number": "360-478-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULON",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "PHYSICAL THERAPY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "WA",
            "license": "2015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4111589",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.