Healthcare Provider Details

I. General information

NPI: 1013857556
Provider Name (Legal Business Name): RUBY BEHAVIORAL CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BEACH STREET
SOUTH BEND WA
98527
US

IV. Provider business mailing address

177 NE WASHINGTON AVE
CHEHALIS WA
98532-2647
US

V. Phone/Fax

Practice location:
  • Phone: 360-219-6781
  • Fax:
Mailing address:
  • Phone: 360-219-6781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ALIZA QUINLAN
Title or Position: CEO
Credential: LABA
Phone: 360-219-6781