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General NPI Number Information
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NPI Number | 1285215426
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Entity Type | Individual
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Provider Name | JASON CHRISTOPHER RUBIN
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Gender |
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 2370 130TH AVE NE STE 100
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City | BELLEVUE
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State | WA
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Zip | 98005-1770
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Country | US
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Telephone | 425-691-5884
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Fax |
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Provider Business Mailing Address
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Address Line | 2370 130TH AVE NE STE 100
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City | BELLEVUE
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State | WA
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Zip | 98005-1770
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Country | US
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Telephone | 425-691-5884
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SC61184464
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License Number State | WA
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