Jasiah Took Ruby-Schultz, CDA
Dental Assistant in Lacey, WA. Individual provider (NPI-1).
NPI number1245084979
StatusActive
Last updated in NPPESApr 17, 2024
Details
- NPI
- 1245084979
- Entity type
- Individual (NPI-1)
- Name
- Jasiah Took Ruby-Schultz
- Credential
- CDA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 17, 2024
- Certification date
- Apr 17, 2024
- Last updated
- Apr 17, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 126800000X | Dental Assistant | 264321 | WA | Yes |
Practice location
8050 Freedom Ln Ne Ste CLacey, WA 98516-4761
Phone 360-464-4597
Mailing address
1801 Evergreen Park Ct Sw Apt 23Olympia, WA 98502-5859
Phone 206-434-0877
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