Healthcare Provider Details

I. General information

NPI: 1700870946
Provider Name (Legal Business Name): KAREN MARIE RUHL CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN MANGAN

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 11/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33501 1ST WAY S
FEDERAL WAY WA
98003-6208
US

IV. Provider business mailing address

33501 1ST WAY S
FEDERAL WAY WA
98003-6208
US

V. Phone/Fax

Practice location:
  • Phone: 253-838-2400
  • Fax: 253-874-1637
Mailing address:
  • Phone: 253-838-2400
  • Fax: 253-874-1637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW1309
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60268688
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAP60268688
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP60268688
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP60268688
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: