Ruzicka, Radene

Ruzicka, Radene is an sole proprietor health care provider with primary practice located at 516 E 1St St , Aberdeen WA 98520-4106. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Ruzicka, Radene can be contacted via phone (360) 350-4010.

Contact Information

Primary practice address
516 E 1St St Aberdeen WA 98520-4106
Phone: (360) 350-4010
Fax: (360) 533-9825
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X LP60886624 Washington

Profile Details

NPI number 1184243867
LBN Legal business name Ruzicka, Radene
Credentials LP60886624
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 13th, 2020
Last updated Apr 13th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184243867 NPPES
California MEDICAID 33-0652655

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