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NPI Code Detail

MEDICARE: RUBY YOUNG

MEDICARE: RUBY YOUNG
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
1363LG0600XGerontology Nurse PractitionerAP60835040WA

General Provider Information

NPI Number : 1649774316
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUBY YOUNG
Provider Business Mailing Address
First Line : 1201 PACIFIC AVE STE 600
Second Line :
City : TACOMA
State : WA
Zip : 98402-4384
Country : US
Telephone Number : 253-203-3131
Fax Number :
Provider Business Practice Location Address
First Line : 1201 PACIFIC AVE STE 600
Second Line :
City : TACOMA
State : WA
Zip : 98402-4384
Country : US
Telephone Number : 253-203-3131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2018
Last Update Date : 03/19/2018

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Directions to “ RUBY YOUNG ” Practice Location

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