Fudge, Teresa Marie

Fudge, Teresa Marie is an individual health care provider with primary practice located at 412 Sw 12Th Ave , Portland OR 97205-2329. She recently has 4 registered licenses in different health care specialties including Nursing Service Providers / Addiction (Substance Use Disorder), Nursing Service Providers / Community Health, Nursing Service Providers / Psychiatric/Mental Health, Behavioral Health & Social Service Providers / Mental Health. Nursing Service Providers / Psychiatric/Mental Health is her primary health care specialty. Fudge, Teresa Marie can be contacted via phone (503) 228-7134.

Contact Information

Primary practice address
412 Sw 12Th Ave Portland OR 97205-2329
Phone: (503) 228-7134
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X Oregon
Nursing Service Providers / Community Health 163WC1500X Oregon
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X Oregon
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Oregon

Profile Details

NPI number 1144366683
LBN Legal business name Fudge, Teresa Marie
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated Jan 18th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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