Individual
MARILYN L RUDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19250 SW 65TH AVE, SUITE 135, TUALATIN, OR 97062-7452
(503) 692-8560
(503) 692-8562
Mailing address
1585 SW MARLOW AVE, SUITE 101, PORTLAND, OR 97225-5176
(503) 692-8560
(503) 691-0866
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
MD09135
OR
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD09135
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01797-0
—
OR
Enumeration date
06/17/2006
Last updated
04/20/2012
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