Individual
MR. ROBERT LEE MCGRUDER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP-CNP
Contact information
Practice address
834 SHERIDAN ST, PORT TOWNSEND, WA 98368-2443
(360) 385-2200
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00167352
WA
363L00000X
Nurse Practitioner
Primary
AP61284940
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2213002
—
WA
Enumeration date
05/30/2017
Last updated
02/18/2025
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