Individual
DR. JESSIE ROBERTS FUDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 502-3600
Mailing address
2930 MAPLE STREET, EVERETT, WA 98201
(425) 502-3600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD 60141711
WA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MD 60141711
WA
Other
Enumeration date
09/20/2007
Last updated
04/07/2021
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