Healthcare Provider Details

I. General information

NPI: 1225373863
Provider Name (Legal Business Name): MRS. KARA C RUBENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS KARA C RYAN

II. Dates (important events)

Enumeration Date: 12/09/2012
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19225 8TH AVE NE STE 201
POULSBO WA
98370-5002
US

IV. Provider business mailing address

19225 8TH AVE NE STE 201
POULSBO WA
98370-5002
US

V. Phone/Fax

Practice location:
  • Phone: 510-633-3221
  • Fax:
Mailing address:
  • Phone: 510-633-3221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12471
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number61589913
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: