NPI 1235418625

Monica Rudestam

Organisation Preferred Provider Organization Aurora, OR

Practice location

Address: 14936 3rd St NE, Aurora, OR 97002-9221
Phone: (971) 409-4049
Mailing address: PO Box 115, Aurora, OR 97002-0115

Authorised official

Name: Monica Rudestam
Title: Sole Proprietor
Phone: (971) 409-4049

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence AC150554 (OR)

Other Preferred Provider Organization providers in Oregon →

Registry record

NPI: 1235418625
Entity type: Organization
NPI issued: 16 Aug 2011
Record last updated: 16 Aug 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.