Provider Demographics
NPI:1508162371
Name:VARGAS, RUTHANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:RUTHANNE
Middle Name:
Last Name:VARGAS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:RUTHANNE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6659 KIMBALL DR STE D403
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-5141
Mailing Address - Country:US
Mailing Address - Phone:253-854-1387
Mailing Address - Fax:253-858-3856
Practice Address - Street 1:6659 KIMBALL DR STE D403
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-5141
Practice Address - Country:US
Practice Address - Phone:253-854-1387
Practice Address - Fax:253-858-3856
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00001423174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist