Provider Demographics
NPI:1083971113
Name:RUTHERFORD, JAMES (ACADC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:RUTHERFORD
Suffix:
Gender:M
Credentials:ACADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10040
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99209-1040
Mailing Address - Country:US
Mailing Address - Phone:509-951-8687
Mailing Address - Fax:
Practice Address - Street 1:3144 W ELOIKA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-7327
Practice Address - Country:US
Practice Address - Phone:509-951-8687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-13
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA203646OtherINTERNATIONAL CERTIFICATION & RECIPROCITY CONSORTIUM