Most Relevant Information
Provider Data
| NPI Number: | 1003275082 |
| Provider Name: | LETISIA RUIZ |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/18/2016 |
| Last Updated: | 10/14/2020 |
Provider Practice Location
70362 KUNZE LN
BOARDMAN
OR
978188013
Practice Location Phone/Fax
| Phone: | 5414813233 |
| Fax: | 5414813234 |
Provider Mailing Location
3587 HEATHROW WAY
MEDFORD
OR
975044004
Provider Mailing Phone/Fax
| Phone: | 5413142328 |
| Fax: |