Provider Demographics
NPI:1710227426
Name:RUDE, LAURA (CHT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:RUDE
Suffix:
Gender:F
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26611 SE 152ND ST
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8273
Mailing Address - Country:US
Mailing Address - Phone:425-427-6495
Mailing Address - Fax:
Practice Address - Street 1:310 3RD AVE NE
Practice Address - Street 2:SUITE 117
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3300
Practice Address - Country:US
Practice Address - Phone:425-427-6495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHP60115378174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist