Provider Demographics
NPI:1619251170
Name:RUTLEDGE, SCOTT (LMFT)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:RUTLEDGE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4573 193RD PL SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-9329
Mailing Address - Country:US
Mailing Address - Phone:206-355-5884
Mailing Address - Fax:
Practice Address - Street 1:310 3RD AVE NE STE 109
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3346
Practice Address - Country:US
Practice Address - Phone:206-355-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60429194106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist