Provider Demographics
NPI:1669585907
Name:RUTHERFORD, EVE M (DDS)
Entity type:Individual
Prefix:DR
First Name:EVE
Middle Name:M
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2744
Mailing Address - Country:US
Mailing Address - Phone:360-568-6017
Mailing Address - Fax:360-568-9331
Practice Address - Street 1:229 AVENUE D
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2744
Practice Address - Country:US
Practice Address - Phone:360-568-6017
Practice Address - Fax:360-568-9331
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE91411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice