Provider Demographics
NPI:1285215426
Name:RUBIN, JASON CHRISTOPHER
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:CHRISTOPHER
Last Name:RUBIN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:JASMINE
Other - Middle Name:JASON
Other - Last Name:RUBIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JASMINE JASON RUBIN
Mailing Address - Street 1:2370 130TH AVE NE STE 100
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1770
Mailing Address - Country:US
Mailing Address - Phone:425-691-5884
Mailing Address - Fax:
Practice Address - Street 1:2370 130TH AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1770
Practice Address - Country:US
Practice Address - Phone:425-691-5884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61184464101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health