Provider Demographics
NPI:1356431886
Name:DUDLEY, DENISE F (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:F
Last Name:DUDLEY
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3015 SQUALICUM PKWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1945
Mailing Address - Country:US
Mailing Address - Phone:360-733-4800
Mailing Address - Fax:360-733-2879
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:SUITE 260
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1945
Practice Address - Country:US
Practice Address - Phone:360-733-4800
Practice Address - Fax:360-733-2879
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2011-02-24
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Provider Licenses
StateLicense IDTaxonomies
WAMD00038911207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8255572Medicaid
WAG10215Medicare UPIN
WA8255572Medicaid