Individual
DR. ALYSA ANN RUDDELL
Active
Individual
DR. ALYSA ANN RUDDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY1268
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11597
CRIME VICTIM'S FUND
WA
01
—
33375
TRIWEST/CHAMPUS
WA
05
—
7070121
—
WA
01
—
947416
WASHINGTON STATE PROVIDER
WA
01
—
RU7443
BLUE CROSS/BLUE SHIELD
WA
Enumeration date
10/03/2006
Last updated
07/08/2007
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