Healthcare Provider Details

I. General information

NPI: 1457472581
Provider Name (Legal Business Name): JENNIFER VALIA RUTHENSTEINER DE LA PAZ N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER VALIA RABINOVICH N.D.

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5492 MYRTLE AVE
FREELAND WA
98249-9655
US

IV. Provider business mailing address

PO BOX 554
FREELAND WA
98249-0554
US

V. Phone/Fax

Practice location:
  • Phone: 360-437-6022
  • Fax: 866-277-7173
Mailing address:
  • Phone: 360-331-2464
  • Fax: 866-277-7173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1312
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT00001312
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: