Kudoja, Mary N

Kudoja, Mary N is an sole proprietor health care provider with primary practice located at 10151 Se Sunnyside Rd Ste 100 , Clackamas OR 97015-5705. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Kudoja, Mary N can be contacted via phone (503) 659-0880.

Contact Information

Primary practice address
10151 Se Sunnyside Rd Ste 100 Clackamas OR 97015-5705
Phone: (503) 659-0880
Fax: (503) 659-0880
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 6843-33 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 10001428 Oregon

Profile Details

NPI number 1770945263
LBN Legal business name Kudoja, Mary N
Credentials FNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2016
Last updated Jul 12th, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1770945263 NPPES
Wisconsin MEDICAID 100054720

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