Juan R Ruiz, CDPT
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Forks, WA
NPI 1689830366 · NPPES record last updated Aug 1, 2008
Key facts
- NPI
- 1689830366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- RC00057250 (WA)
- Practice address
- 530 Bogachiel Way
Forks, WA 98331-9120 - Phone
- (360) 374-5011
- Fax
- (360) 374-6691
- NPI assigned
- Aug 1, 2008
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RC00057250 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | RC00057250 | WA | Yes |
Addresses
Primary practice location
530 Bogachiel Way
Forks, WA 98331-9120
Mailing address
530 Bogachiel Way
Forks, WA 98331-9120
Phone (360) 374-5011
Other providers in Forks, WA
- Richard L Dickson, M.D.
- Richard L. Dickson
- Bruce Robinson
- Vernon Rondeau
- Ann E Rowe
- Sarah Sanders
- Anand Selvam
- Susan Lee Shane
- John M Shima
- Gregory Michael Smith
All providers in Forks, WA · Addiction (Substance Use Disorder) Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.