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Individual

JAIME D. RUDDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-2675
Mailing address
PO BOX 24366, SEATTLE, WA 98124-0366
(206) 598-0502
(206) 598-0516

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00129892
WA
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
AP300006728
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0208340
LABOR & INDUSTRIES
WA
01
09779U
REGENCE BLUESHIELD
WA
05
9641564
WA
Enumeration date
07/06/2006
Last updated
02/04/2009
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