MEDICARE: DR. RUTH A. FREEMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD00036837	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073502829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTH A. FREEMAN M.D.

Provider Business Mailing Address
First Line	:	1908 201ST PL SE STE 100
Second Line	:
City	:	BOTHELL
State	:	WA
Zip	:	98012-8572
Country	:	US
Telephone Number	:	425-219-4720
Fax Number	:	425-949-7059

Provider Business Practice Location Address
First Line	:	1908 201ST PL SE STE 100
Second Line	:
City	:	BOTHELL
State	:	WA
Zip	:	98012-8572
Country	:	US
Telephone Number	:	425-219-4720
Fax Number	:	425-949-7059

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	03/13/2019

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