Individual provider · Type 1 NPI

Ladd Douglas Rutherford Jr., PA-C

Medical Physician Assistant · Shelton, WA

NPI number 1235809005 Active

Practice location

1701 N 13th St
Shelton, WA 98584-2077

Fax (888) 985-0168

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1235809005

Ladd Douglas Rutherford Jr., PA-C's National Provider Identifier is 1235809005, issued on Sep 14, 2021. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Shelton, WA. The record was last updated on Jan 16, 2023.