Provider Demographics
NPI:1265580427
Name:TONGEN, RUTH (RN, LAC)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:TONGEN
Suffix:
Gender:F
Credentials:RN, LAC
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:TONGEN
Other - Last Name:EATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, LAC
Mailing Address - Street 1:4820 WEST 77TH STREET
Mailing Address - Street 2:SUITE 145
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4822
Mailing Address - Country:US
Mailing Address - Phone:952-920-9830
Mailing Address - Fax:
Practice Address - Street 1:4820 WEST 77TH STREET
Practice Address - Street 2:SUITE 145
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4822
Practice Address - Country:US
Practice Address - Phone:952-920-9830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1055423163W00000X
MN1297171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171100000XOther Service ProvidersAcupuncturist