Provider Demographics
NPI:1811885320
Name:DR. LILIANA RUTO'S MOBILE HEALTH CLINIC AND DISPENSARY PLLC DHH-DNM
Entity type:Organization
Organization Name:DR. LILIANA RUTO'S MOBILE HEALTH CLINIC AND DISPENSARY PLLC DHH-DNM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIANA
Authorized Official - Middle Name:ARIELA
Authorized Official - Last Name:ESTRADA RUTO
Authorized Official - Suffix:
Authorized Official - Credentials:ND, DHH, DNM , BCIP
Authorized Official - Phone:253-220-6191
Mailing Address - Street 1:PO BOX 4521
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98063-4521
Mailing Address - Country:US
Mailing Address - Phone:253-220-6191
Mailing Address - Fax:
Practice Address - Street 1:2367 TACOMA AVE S STE 120
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-1409
Practice Address - Country:US
Practice Address - Phone:253-220-6191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No251E00000XAgenciesHome Health
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No261QM1000XAmbulatory Health Care FacilitiesClinic/CenterMigrant Health
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty