Provider Demographics
NPI:1104053727
Name:RUDOLF, VANIA P (MD)
Entity type:Individual
Prefix:
First Name:VANIA
Middle Name:P
Last Name:RUDOLF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 UNIVERSITY ST
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1176
Mailing Address - Country:US
Mailing Address - Phone:206-320-4476
Mailing Address - Fax:206-568-7043
Practice Address - Street 1:5300 TALLMAN AVE NW
Practice Address - Street 2:ADDICTION RECOVERY SERVICE, SWEDISH MEDICAL GROUP
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3932
Practice Address - Country:US
Practice Address - Phone:206-781-6209
Practice Address - Fax:206-781-6183
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2021-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA60225581174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist