Basic Information
Provider Information
NPI: 1700870946
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RUHL
FirstName: KAREN
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MANGAN
OtherFirstName: KAREN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 33501 1ST WAY S
Address2:  
City: FEDERAL WAY
State: WA
PostalCode: 980036208
CountryCode: US
TelephoneNumber: 2538382400
FaxNumber: 2538741637
Practice Location
Address1: 33501 1ST WAY S
Address2:  
City: FEDERAL WAY
State: WA
PostalCode: 980036208
CountryCode: US
TelephoneNumber: 2538382400
FaxNumber: 2538741637
Other Information
ProviderEnumerationDate: 09/02/2005
LastUpdateDate: 11/18/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XNMW1309CAN Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 
363L00000XAP60268688WAN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LX0001XAP60268688WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
363LW0102XAP60268688WAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
367A00000XAP60268688WAN Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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