Provider Demographics
NPI:1699575852
Name:MUTA, RUTH WAMUYU
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:WAMUYU
Last Name:MUTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 91ST ST S
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-9115
Mailing Address - Country:US
Mailing Address - Phone:206-371-6393
Mailing Address - Fax:
Practice Address - Street 1:102 23RD AVE SE STE A
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-4501
Practice Address - Country:US
Practice Address - Phone:253-987-5561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61633195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health