Provider Demographics
NPI:1164543914
Name:RUHL, SARAH (LISW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RUHL
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 MAIN ST STE 500
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-2972
Mailing Address - Country:US
Mailing Address - Phone:360-931-0113
Mailing Address - Fax:360-699-0708
Practice Address - Street 1:1104 MAIN ST STE 500
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2972
Practice Address - Country:US
Practice Address - Phone:360-931-0113
Practice Address - Fax:360-699-0708
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000062341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical