Healthcare Provider Details

I. General information

NPI: 1518340728
Provider Name (Legal Business Name): JAMES ALEXANDER RUVALCABA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SW HOLDEN ST
SEATTLE WA
98126-3505
US

IV. Provider business mailing address

2019 BOREN AVE APT 4109
SEATTLE WA
98121-3151
US

V. Phone/Fax

Practice location:
  • Phone: 206-933-7000
  • Fax:
Mailing address:
  • Phone: 414-477-8571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number263521
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number67904
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD61484786
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: