Individual
JODY RUDRUD GRANDORFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 6TH AVE SE, SUITE 201, LACEY, WA 98503-1042
(360) 459-8311
Mailing address
4200 6TH AVE SE, SUITE 201, LACEY, WA 98503-1042
(360) 459-8311
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00080230
WA
Other
Enumeration date
04/08/2024
Last updated
04/08/2024
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