Provider Demographics
NPI:1235978479
Name:RUGGLES, CARLA MARILYN (PT, DPT)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:MARILYN
Last Name:RUGGLES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CARLY
Other - Middle Name:MARILYN
Other - Last Name:RUGGLES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4636 194TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-9357
Mailing Address - Country:US
Mailing Address - Phone:425-677-5104
Mailing Address - Fax:
Practice Address - Street 1:20 OHLONE PKWY STE D
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3767
Practice Address - Country:US
Practice Address - Phone:831-724-8235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3075322251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic