Provider Demographics
NPI:1790861870
Name:LEWING, RUTH ASHLEY (LMP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ASHLEY
Last Name:LEWING
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N 200TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3001
Mailing Address - Country:US
Mailing Address - Phone:206-920-6978
Mailing Address - Fax:206-629-5386
Practice Address - Street 1:105 N 200TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-3001
Practice Address - Country:US
Practice Address - Phone:206-920-6978
Practice Address - Fax:206-629-5386
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019598225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0188043OtherWA LABOR & INDUSTRIES