Individual
MS. KATHLEEN ANNETTE PUDERBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
6760 MISSION RD, EVERSON, WA 98247-9749
(360) 966-2106
(360) 966-2304
Mailing address
6432 OLSON RD, FERNDALE, WA 98248-8514
(360) 383-0693
(360) 383-0838
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
AP30003425
WA
363LW0102X
Women's Health Nurse Practitioner
Primary
AP30003425
WA
Other
Enumeration date
11/02/2005
Last updated
12/21/2011
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