Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD00024942 | WA |
NPI | 1851326722 |
---|---|
Provider Name | Dr. Joy P Ruiz-Molleston |
First Address | Tacoma, WA 98467-3974 |
Second Address | Lakewood, WA 98499-8120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 20/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1084425 | (05) | WA |
F36271 | (02) | |
RU5122 | REGENCE (01) | WA |