Provider Demographics
NPI:1386517688
Name:RUDINE, GINA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:RUDINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 FAIRVIEW ST APT 1
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-2969
Mailing Address - Country:US
Mailing Address - Phone:808-638-1809
Mailing Address - Fax:
Practice Address - Street 1:132 W MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-2746
Practice Address - Country:US
Practice Address - Phone:541-507-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor