Provider Demographics
NPI:1225113186
Name:RUFF, CHAUNCE (PA-C)
Entity Type:Individual
Prefix:
First Name:CHAUNCE
Middle Name:
Last Name:RUFF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 TORBETT ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2604
Mailing Address - Country:US
Mailing Address - Phone:509-946-7646
Mailing Address - Fax:509-946-7666
Practice Address - Street 1:310 TORBETT ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2604
Practice Address - Country:US
Practice Address - Phone:509-946-7646
Practice Address - Fax:509-946-7666
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10005108363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8476830Medicaid
WA0214583OtherLABOR & INDUSTRIES
WAG8862462Medicare PIN
WA0214583OtherLABOR & INDUSTRIES