Individual
DR. JON LESLIE RUCKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1402 S BROOKSIDE TER, TACOMA, WA 98465-1210
(253) 448-8690
Mailing address
1402 S BROOKSIDE TER, TACOMA, WA 98465-1210
(253) 448-8690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00024572
WA
207R00000X
Internal Medicine Physician
MD-11129
HI
Other
Enumeration date
03/05/2008
Last updated
09/05/2013
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