Provider Demographics
NPI:1639240385
Name:RUTTER, LINDA MARIE (RPJ)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MARIE
Last Name:RUTTER
Suffix:
Gender:F
Credentials:RPJ
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 24269
Mailing Address - Street 2:BIRTH TO THREE DEVELOPMENTAL CENTER
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98093-1269
Mailing Address - Country:US
Mailing Address - Phone:253-874-5445
Mailing Address - Fax:253-874-0687
Practice Address - Street 1:35535 6TH PLACE SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023
Practice Address - Country:US
Practice Address - Phone:253-874-5445
Practice Address - Fax:253-874-0687
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00000738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2199RUOtherREGENCE BLUE SHIELD
WA8334096Medicaid