Provider Demographics
NPI:1700192044
Name:RUHOY, ILENE SUE (MD)
Entity Type:Individual
Prefix:
First Name:ILENE
Middle Name:SUE
Last Name:RUHOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 NE BLAKELEY ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3100
Mailing Address - Country:US
Mailing Address - Phone:206-379-1213
Mailing Address - Fax:206-492-2003
Practice Address - Street 1:2900 NE BLAKELEY ST
Practice Address - Street 2:SUITE C
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3100
Practice Address - Country:US
Practice Address - Phone:206-379-1213
Practice Address - Fax:206-492-2003
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD601024552084N0402X
WAML601825722084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology