Individual
DR. PAETRA JANE RUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19917 7TH AVE NE STE 203, POULSBO, WA 98370-6555
(360) 824-5474
(360) 994-4975
Mailing address
1793 13TH ST SE, SALEM, OR 97302-2541
(503) 362-8385
(503) 362-8435
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2015026116
MO
207N00000X
Dermatology Physician
Primary
MD61231855
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200024055
—
MO
Enumeration date
06/22/2011
Last updated
10/15/2024
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