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Individual

MS. REBECCA SARA RUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, OCS, CSCS

Contact information

Practice address
7719 64TH AVE E, PUYALLUP, WA 98371-5515
(253) 200-0741
Mailing address
7719 64TH AVE E, PUYALLUP, WA 98371-5515
(253) 200-0741

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT00008904
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0193067
L&I
WA
05
7121973
WA
Enumeration date
03/13/2007
Last updated
03/02/2020
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