Provider Demographics
NPI:1831209782
Name:PEARCE, RUBY D (MA)
Entity type:Individual
Prefix:MS
First Name:RUBY
Middle Name:D
Last Name:PEARCE
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:PO BOX 494
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-0494
Mailing Address - Country:US
Mailing Address - Phone:425-508-3827
Mailing Address - Fax:
Practice Address - Street 1:2804 GRAND AVE
Practice Address - Street 2:SUITE #207
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3430
Practice Address - Country:US
Practice Address - Phone:425-508-3827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60167619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health