Iredale, Trudy A
Iredale, Trudy A is an individual health care provider with primary practice located at 1804 Se 170Th Ave , Vancouver WA 98683-3474. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Iredale, Trudy A can be contacted via phone (360) 991-0134.Contact Information
Primary practice address
1804 Se 170Th Ave
Vancouver WA 98683-3474
Phone: (360) 991-0134
Fax: (360) 991-0154
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1597 | Oregon |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PY00003097 | Washington |
Profile Details
| NPI number | 1770649402 |
|---|---|
| LBN Legal business name | Iredale, Trudy A |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2006 |
| Last updated | Aug 13th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770649402 | NPPES |
| Other | 1770649402 | NPI | |
| Other | 1841811783 | NPI | |
| MEDICAID | 164936 | NPI |
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