Provider Demographics
NPI:1003963950
Name:RUDZINSKI, ERIN (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:RUDZINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SANDPOINT WAY NE, A6901
Mailing Address - Street 2:DEPARTMENT OF LABORATORIES
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105
Mailing Address - Country:US
Mailing Address - Phone:206-987-2103
Mailing Address - Fax:206-987-3840
Practice Address - Street 1:4800 SANDPOINT WAY NE, A6901
Practice Address - Street 2:DEPARTMENT OF LABORATORIES
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105
Practice Address - Country:US
Practice Address - Phone:206-987-2103
Practice Address - Fax:206-987-3840
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA390200000X
WAMD60022127207ZP0102X, 207ZP0213X
ORMD153554207ZP0102X, 207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology