Individual
MR. WILLIAM TIMOTHY DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
17070 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-4960
(503) 303-4000
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-152900
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10010240
OR
Other
Enumeration date
11/12/2015
Last updated
10/30/2023
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