Provider Demographics
NPI:1952107229
Name:DELAZERDA, RUDENA MARIE
Entity type:Individual
Prefix:
First Name:RUDENA
Middle Name:MARIE
Last Name:DELAZERDA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:DENA
Other - Middle Name:MARIE
Other - Last Name:STRATMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5415 SW WESTGATE DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-2409
Mailing Address - Country:US
Mailing Address - Phone:503-645-3581
Mailing Address - Fax:
Practice Address - Street 1:820 NW WADE ST UNIT 9
Practice Address - Street 2:
Practice Address - City:ESTACADA
Practice Address - State:OR
Practice Address - Zip Code:97023-9594
Practice Address - Country:US
Practice Address - Phone:971-323-4867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR175T00000X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist