Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 9474 | WA |
NPI | 1053312769 |
---|---|
Provider Name | Dr. Frank P Rudey |
First Address | Renton, WA 98055-5772 |
Second Address | Renton, WA 98055-5700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 08/07/2007 |