Provider Demographics
NPI:1073960977
Name:BAILEY, RUTH (DPT)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:BAILEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 N KALAHEO AVE
Mailing Address - Street 2:SUITE C-316
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1866
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1525 WILMINGTON DR
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-7722
Practice Address - Country:US
Practice Address - Phone:253-212-9670
Practice Address - Fax:253-625-7361
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60757887225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist