Most Relevant Information
Provider Data
| NPI Number: | 1003258344 |
| Provider Name: | JESSICA A DUDLEY FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 201393181NP-PP |
Most Important Dates
| Enumeration Date: | 07/29/2013 |
| Last Updated: | 12/24/2021 |
Provider Practice Location
3550 N INTERSTATE AVE
PORTLAND
OR
972271196
Practice Location Phone/Fax
| Phone: | 5037461575 |
| Fax: |
Provider Mailing Location
3550 N INTERSTATE AVE
PORTLAND
OR
972271196
Provider Mailing Phone/Fax
| Phone: | 5037461575 |
| Fax: |