Individual
DR. TRUDY A IREDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1804 SE 170TH AVE, VANCOUVER, WA 98683-3474
(360) 991-0134
(360) 991-0154
Mailing address
1804 SE 170TH AVE, VANCOUVER, WA 98683-3474
(360) 991-0134
(360) 991-0154
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1597
OR
103TC0700X
Clinical Psychologist
Primary
PY00003097
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
01
—
1770649402
NPI
—
01
—
1841811783
TYPE II NPI
—
Enumeration date
12/28/2006
Last updated
08/13/2020
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