Provider Demographics
NPI:1659329878
Name:RUFF-NELSON, BETTE SUE (LMP)
Entity type:Individual
Prefix:
First Name:BETTE
Middle Name:SUE
Last Name:RUFF-NELSON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 138
Mailing Address - Street 2:
Mailing Address - City:HUSUM
Mailing Address - State:WA
Mailing Address - Zip Code:98623-0138
Mailing Address - Country:US
Mailing Address - Phone:509-493-3142
Mailing Address - Fax:
Practice Address - Street 1:1000 EAST JEWETT AVENUE
Practice Address - Street 2:
Practice Address - City:WHITE SALMON
Practice Address - State:WA
Practice Address - Zip Code:98672
Practice Address - Country:US
Practice Address - Phone:509-493-3142
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00005767174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist