Individual
AMANDA J TUDEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 NW VAUGHN ST, PORTLAND, OR 97210-5311
(503) 944-6820
Mailing address
3443 SE WASHINGTON ST, PORTLAND, OR 97214-3140
13522783940
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
353597
OR
Other
Enumeration date
07/26/2017
Last updated
07/26/2017
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