Provider Demographics
NPI:1851564504
Name:RAMOZ, REUBEN RUDY (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:REUBEN
Middle Name:RUDY
Last Name:RAMOZ
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 BUSTER RD
Mailing Address - Street 2:
Mailing Address - City:TOPPENISH
Mailing Address - State:WA
Mailing Address - Zip Code:98948-9792
Mailing Address - Country:US
Mailing Address - Phone:509-865-2102
Mailing Address - Fax:509-865-4986
Practice Address - Street 1:401 BUSTER RD
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-9792
Practice Address - Country:US
Practice Address - Phone:509-865-2102
Practice Address - Fax:509-865-4986
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243601207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2050740Medicaid