Provider Demographics
NPI:1164647046
Name:DUDLEY, HARRY C (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:C
Last Name:DUDLEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7600 NE 41ST ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6728
Mailing Address - Country:US
Mailing Address - Phone:360-253-6425
Mailing Address - Fax:360-253-3196
Practice Address - Street 1:7600 NE 41ST ST
Practice Address - Street 2:SUITE 310
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6791
Practice Address - Country:US
Practice Address - Phone:360-253-6425
Practice Address - Fax:360-253-3196
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA1794103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic