MRS. STACY MARIE RUDY (NPI# 1154713188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154713188 |
| Entity Type | Individual |
| Full Name | MRS. STACY MARIE RUDY |
| Other Name | STACY MARIE ABRAHAM |
| Credential | PA-C |
| Practice Address |
6640 Sw Redwood Ln Portland OR 97224-7187 |
| Practice Telephone | 5036207358 |
| Mailing Telephone | 5036207358 |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2016-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA179627 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6640 SW REDWOOD LN |
| City | PORTLAND |
| State | OR |
| Zip Code | 97224-7187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558311688 | Suvarna Reddy Palla | Specialist | 6640 Sw Redwood Ln, Portland, OR 97224-7187 | 2006-05-11 |
| 1538582903 | Haley Gail Trontel | Psychologist | 6640 Sw Redwood Ln, Portland, OR 97224 | 2014-01-21 |
| 1750656161 | Michael Ryan Shrifter | Psychologist | 6640 Sw Redwood Ln, Portland, OR 97224-7187 | 2012-03-19 |
| 1023380979 | Miles Percy Holland | Nurse Practitioner | 6640 Sw Redwood Ln, Portland, OR 97224-7187 | 2012-02-07 |
| 1780848499 | Ann Marie Paulsen | Internal Medicine | 6640 Sw Redwood Ln, Portland, Portland, OR 97224-7187 | 2008-07-11 |
| 1831362482 | Arete Nw LLC | Specialist | 6640 Sw Redwood Ln, Portland, OR 97224-7187 | 2008-04-03 |
| 1740459478 | Arete Nw, LLC | Specialist | 6640 Sw Redwood Ln, Portland, OR 97224-7187 | 2008-02-27 |
| 1366642746 | Brooke M Madden | Psychiatry & Neurology | 6640 Sw Redwood Ln, Portland, OR 97224-7187 | 2007-07-23 |
| 1699977405 | Sheilla Treacy Ellsworth | Physical Therapist | 6640 Sw Redwood Ln, Suite 300, Portland, OR 97224-7187 | 2007-06-04 |
| 1972705986 | Arin Short | Physical Therapist | 6640 Sw Redwood Ln, Portland, OR 97224-7187 | 2007-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973139 | Katherine Raineri | Psychologist | 7213 Sw Hazel Fern Rd, Tigard, OR 97224 | 2019-07-10 |
| 1871064618 | Stacey A Wenzel | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Rd.,suite 201, Tigard, OR 97224 | 2018-12-05 |
| 1376010090 | Meredith Rae Brezinski | Physical Therapist | 18019 Sw Boones Ferry Road, Tigard, OR 97224 | 2018-10-31 |
| 1649759358 | Viktoriya A Chiliy | Behavior Technician | 15290 Sw Royalty Parkway, Tigard, OR 97224 | 2018-08-13 |
| 1609384866 | Rachel E King | Physical Therapist | 18040 Sw Lower Boones Ferry Rd Ste 200, Tigard, OR 97224 | 2018-01-22 |
| 1689190134 | Isabelle Cooper Klee Caballero | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Road Suite 201, Tigard, OR 97224 | 2017-08-16 |
| 1427573146 | Breanna M Sandefur | Behavior Technician | 15290 Sw Royalty Pkwy, Tigard, OR 97224 | 2017-08-03 |
| 1083141196 | Krista Espenship | Registered Nurse | 8032 Sw Ashford St, Tigard, OR 97224 | 2017-05-19 |
| 1275067928 | Emily Elizabeth Myers | Behavioral Analyst | 15290 Royalty Parkway, Tigard, OR 97224 | 2017-04-19 |
| 1235684937 | Melanie Salvador | Nurse Practitioner | 15352 Sw Oakmont Pl, Tigard, OR 97224 | 2016-08-23 |
| Find all providers in zip 97224 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427676493 | Lindsey Louise Peterson | Physician Assistant | 3505 N Williams Ave, Portland, OR 97227-1437 | 2020-07-07 |
| 1518584036 | Abigail Nichole Dumont | Physician Assistant | 6064 Sw 30th Ave, Portland, OR 97239-1018 | 2020-06-30 |
| 1336769637 | Molly Tanguay | Physician Assistant | 23 Bramhall St, Portland, ME 04102-3121 | 2020-04-16 |
| 1063040525 | Jessica Nursick | Physician Assistant | 26 Sand Hill Rd, Portland, CT 06480-1737 | 2020-03-31 |
| 1689217630 | Evan Eisher | Physician Assistant | 3809 Se Stephens St, Portland, OR 97214-5248 | 2019-10-22 |
| 1508407941 | Amie Bates | Physician Assistant | 1040 Nw 22nd Ave # Ll030, Portland, OR 97210-3057 | 2019-10-07 |
| 1558923326 | Mackenzie Graye Mcmillin | Physician Assistant | 1601 Congress St Ste 1, Portland, ME 04102-2145 | 2019-07-02 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1942794839 | Michael Peterson | Physician Assistant | 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 | 2018-06-14 |
| 1306383930 | Rachel Lynn Witowski | Physician Assistant | 2124 Nw Hoyt St, Portland, OR 97210-3215 | 2017-01-20 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.