Provider Demographics
NPI:1609584663
Name:RUTO, LILIANA (PHYSCOTHERAPIST)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:RUTO
Suffix:
Gender:F
Credentials:PHYSCOTHERAPIST
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 4521
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98063-4521
Mailing Address - Country:US
Mailing Address - Phone:786-623-1640
Mailing Address - Fax:
Practice Address - Street 1:30911 1ST AVE S APT 106
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4071
Practice Address - Country:US
Practice Address - Phone:786-623-1640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101200000XBehavioral Health & Social Service ProvidersDrama TherapistGroup - Single Specialty