Provider Demographics
NPI:1851136386
Name:RUIZ, ANYSSA DANIELLE (DPT)
Entity type:Individual
Prefix:
First Name:ANYSSA
Middle Name:DANIELLE
Last Name:RUIZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13321 209TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-9726
Mailing Address - Country:US
Mailing Address - Phone:425-877-8877
Mailing Address - Fax:
Practice Address - Street 1:12911 120TH AVE NE STE E60
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3047
Practice Address - Country:US
Practice Address - Phone:425-298-7190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist