Healthcare Provider Details

I. General information

NPI: 1437960234
Provider Name (Legal Business Name): JONATHAN RUIZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15021 MAIN ST STE K
MILL CREEK WA
98012-1651
US

IV. Provider business mailing address

PO BOX 700688
SAN ANTONIO TX
78270-0688
US

V. Phone/Fax

Practice location:
  • Phone: 800-404-6050
  • Fax: 866-313-3397
Mailing address:
  • Phone: 800-404-6050
  • Fax: 866-313-3397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR.CH.70132853
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number16269
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: