Individual
MS. JESSICA A DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 746-1575
Mailing address
3550 N INTERSTATE AVE, PORTLAND, OR 97227-1196
(503) 746-1575
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201393181NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2036033
—
WA
05
—
500664845
—
OR
Enumeration date
07/29/2013
Last updated
12/24/2021
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