Individual
ANDREA BETH RUOTOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU. D
Contact information
Practice address
5050 NE HOYT ST, SUITE 655, PORTLAND, OR 97213-2991
(503) 488-2400
(503) 231-0121
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
21975
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649216110
—
WA
05
—
181816
—
OR
Enumeration date
06/21/2006
Last updated
12/16/2013
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