Provider Demographics
NPI:1659733988
Name:LUDENIA, JANEL (MOTR/L)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:
Last Name:LUDENIA
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17780 HILL WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-5418
Mailing Address - Country:US
Mailing Address - Phone:763-226-9725
Mailing Address - Fax:
Practice Address - Street 1:12200 SE MCLOUGHLIN BLVD APT 2302
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-7207
Practice Address - Country:US
Practice Address - Phone:763-226-9725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-25
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR274590225X00000X
OR4225175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist