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NPI 1205333762

NPI 1205333762 : JORDAN RUGER LICSW : SPOKANE, WA

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General NPI Number Information
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    NPI Number           |    1205333762
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    Entity Type          |    Individual 
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    Provider Name        |    JORDAN RUGER LICSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/11/2018
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    Last Update Date     |    05/12/2025
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Provider Practice Location Address
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    Address Line         |    5901 N LIDGERWOOD ST STE 223 
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    City                 |    SPOKANE
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    State                |    WA
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    Zip                  |    99208-1122
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    Country              |    US
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    Telephone            |    509-444-8200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    611 N IRON BRIDGE WAY 
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    City                 |    SPOKANE
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    State                |    WA
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    Zip                  |    99202-4932
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    Country              |    US
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    Telephone            |    509-444-8888
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    LW61009161
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    License Number State |    WA
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Taxonomy #2
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    LW61009161
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    License Number State |    WA
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