Provider Demographics
NPI:1902230071
Name:GRAHAM, RUTH JANETTE (MA)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:JANETTE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3397 LARSEN AVE
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-9497
Mailing Address - Country:US
Mailing Address - Phone:206-605-0664
Mailing Address - Fax:
Practice Address - Street 1:3397 LARSEN AVE
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-9497
Practice Address - Country:US
Practice Address - Phone:206-605-0664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor