Individual provider · Type 1 NPI

Teresa Marie Fudge, RN

Psychiatric/Mental Health Registered Nurse · Portland, OR

NPI number 1144366683 Active

Practice location

412 SW 12th Ave
Portland, OR 97205-2329

Mailing address

1318 NW 20th Ave, Suite B
Portland, OR 97209-1671

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Registered Nurse 163WA0400XNone listed
Community Health Registered Nurse 163WC1500XNone listed
Psychiatric/Mental Health Registered Nurse Primary 163WP0808XNone listed
Mental Health Counselor 101YM0800XNone listed

Psychiatric/Mental Health Registered Nurse: Definition to come...

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About NPI 1144366683

Teresa Marie Fudge, RN's National Provider Identifier is 1144366683, issued on Jan 30, 2007. The primary taxonomy on file is Psychiatric/Mental Health Registered Nurse (163WP0808X), and the practice location is in Portland, OR. The record was last updated on Jan 18, 2008.