Provider Demographics
NPI:1780365734
Name:RUGGLES, JENNIFER (CD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RUGGLES
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 N STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-4740
Mailing Address - Country:US
Mailing Address - Phone:253-961-9643
Mailing Address - Fax:
Practice Address - Street 1:3110 N STEVENS ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-4740
Practice Address - Country:US
Practice Address - Phone:253-961-9643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA604818750374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula