Individual
NICOLETTE CORELLA MOORE RUTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSWAIC
Contact information
Practice address
80 159TH PL NE, BELLEVUE, WA 98008-4415
(281) 620-9640
Mailing address
80 159TH PL NE, BELLEVUE, WA 98008-4415
(281) 620-9640
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC61280235
WA
Other
Enumeration date
04/12/2023
Last updated
04/12/2023
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