Individual
NICOLE SUSANNE RUTTENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LMFTA
Contact information
Practice address
17129 32ND AVE NE, LAKE FOREST PARK, WA 98155-5323
(206) 850-6439
Mailing address
17129 32ND AVE NE, LAKE FOREST PARK, WA 98155-5323
(206) 850-6439
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
61073067
WA
Other
Enumeration date
08/08/2020
Last updated
08/08/2020
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