Healthcare Provider Details

I. General information

NPI: 1811885320
Provider Name (Legal Business Name): DR. LILIANA RUTO'S MOBILE HEALTH CLINIC AND DISPENSARY PLLC DHH-DNM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2367 TACOMA AVE S STE 120
TACOMA WA
98402-1409
US

IV. Provider business mailing address

PO BOX 4521
FEDERAL WAY WA
98063-4521
US

V. Phone/Fax

Practice location:
  • Phone: 253-220-6191
  • Fax:
Mailing address:
  • Phone: 253-220-6191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM1000X
TaxonomyMigrant Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. LILIANA ARIELA ESTRADA RUTO
Title or Position: OWNER
Credential: ND, DHH, DNM , BCIP
Phone: 253-220-6191