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Individual

JOHN BRUIN RUGGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
33721 E COLUMBIA AVE., SCAPPOOSE, OR 97056
(503) 418-4222
Mailing address
624 N STAFFORD ST, PORTLAND, OR 97217-1580

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD22472
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
226960
OR
Enumeration date
08/03/2006
Last updated
07/08/2007
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