MEDICARE: SHAWNA RUFF LMP

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	174400000X	Specialist	MA00020435	WA

General Provider Information

NPI Number	:	1578972402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWNA RUFF LMP

Provider Business Mailing Address
First Line	:	1422 HARVARD AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-3813
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1422 HARVARD AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-3813
Country	:	US
Telephone Number	:	206-324-2225
Fax Number	:

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

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	08/05/2014

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Directions to “ SHAWNA RUFF LMP” Practice Location

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