Provider Demographics
NPI:1356166342
Name:DR.RUTO'S PRIVATE PRACTICE
Entity type:Organization
Organization Name:DR.RUTO'S PRIVATE PRACTICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA RUTO
Authorized Official - Suffix:
Authorized Official - Credentials:ND,DHH,DNM,CPC,BCIP
Authorized Official - Phone:786-623-1640
Mailing Address - Street 1:PO BOX 4521
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98063-4521
Mailing Address - Country:US
Mailing Address - Phone:786-623-1640
Mailing Address - Fax:
Practice Address - Street 1:3949 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-4200
Practice Address - Country:US
Practice Address - Phone:786-623-1640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1609584663
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-15
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1000XAmbulatory Health Care FacilitiesClinic/CenterMigrant Health