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General NPI Number Information
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NPI Number | 1528401197
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Entity Type | Individual
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Provider Name | RUTH LUBA VARKOVITZKY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2013
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Last Update Date | 07/24/2013
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Provider Practice Location Address
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Address Line | 9600 VETERANS DR 61-A116-A POC
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City | TACOMA
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State | WA
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Zip | 98493-0001
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Country | US
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Telephone | 253-583-1668
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Fax |
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Provider Business Mailing Address
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Address Line | 9600 VETERANS DR 61-A116-A POC
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City | TACOMA
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State | WA
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Zip | 98493-0001
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Country | US
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Telephone | 253-583-1668
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY60368488
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License Number State | WA
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