Provider Demographics
NPI:1063725505
Name:DAVID P RUOFF, MD, INC, PS.
Entity type:Organization
Organization Name:DAVID P RUOFF, MD, INC, PS.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:RUOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-226-1180
Mailing Address - Street 1:4361 TALBOT RD S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-6226
Mailing Address - Country:US
Mailing Address - Phone:425-226-1180
Mailing Address - Fax:425-235-0695
Practice Address - Street 1:4361 TALBOT RD S
Practice Address - Street 2:SUITE 102
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-6226
Practice Address - Country:US
Practice Address - Phone:425-226-1180
Practice Address - Fax:425-235-0695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00025165207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA06263Medicare UPIN