Provider Demographics
NPI:1689600538
Name:MCCAULEY, RUTH L (PT)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:L
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8007 BAIRD RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-9358
Mailing Address - Country:US
Mailing Address - Phone:360-456-3609
Mailing Address - Fax:
Practice Address - Street 1:PSHCS AMERICAN LAKE DIVISION
Practice Address - Street 2:9600 VETERAN'S DR
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-0001
Practice Address - Country:US
Practice Address - Phone:253-583-1872
Practice Address - Fax:253-589-4068
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist