Provider Demographics
NPI:1528166683
Name:SCHAFFLER, RUTH LAURINE (ARNP)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:LAURINE
Last Name:SCHAFFLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 RUDDELL RD SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-5163
Mailing Address - Country:US
Mailing Address - Phone:360-438-0394
Mailing Address - Fax:360-493-0824
Practice Address - Street 1:5602 RUDDELL RD SE
Practice Address - Street 2:LACEY MEDICAL CLINIC
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5163
Practice Address - Country:US
Practice Address - Phone:360-438-0394
Practice Address - Fax:360-493-0824
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004382363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA120799OtherL & I
WA9261715Medicaid
WA9261715Medicaid