Individual
KRISTEN RUCKDASHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
603 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-4502
(541) 426-6403
Mailing address
603 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-4502
(541) 426-6403
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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