Healthcare Provider Details

I. General information

NPI: 1003963950
Provider Name (Legal Business Name): ERIN R RUDZINSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SANDPOINT WAY NE, A6901 DEPARTMENT OF LABORATORIES
SEATTLE WA
98105
US

IV. Provider business mailing address

4800 SANDPOINT WAY NE, A6901 DEPARTMENT OF LABORATORIES
SEATTLE WA
98105
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2103
  • Fax: 206-987-3840
Mailing address:
  • Phone: 206-987-2103
  • Fax: 206-987-3840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD153554
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number01093368A
License Number StateIN
# 5
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD60022127
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License NumberMD153554
License Number StateOR
# 7
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License NumberMD60022127
License Number StateWA
# 8
Primary TaxonomyN
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License Number01093368A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: