Individual
LADD DOUGLAS RUTHERFORD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1701 N 13TH ST, SHELTON, WA 98584-2077
(360) 426-2653
(888) 985-0168
Mailing address
1701 N 13TH ST, SHELTON, WA 98584-2077
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
01/16/2023
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