Individual
STEPHENIE L RUVALCABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2413 BURCHAM ST, KELSO, WA 98626-5140
(360) 977-3558
Mailing address
2413 BURCHAM ST, KELSO, WA 98626-5140
(360) 977-3558
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
605572988-001-0001
WA
373H00000X
Day Training/Habilitation Specialist
605572988-001-0001
WA
Other
Enumeration date
04/08/2025
Last updated
04/10/2025
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