Doctor Name: | MRS. HEATHER JEAN SANUDO |
NPI Number: | 1023217940 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | |
Business Practice Address: | 24499 Sw Grahams Ferry Rd Wilsonville, OR - 970707523 |
Business Phone Number: | 5035706732 |
Business Fax Number: | |
Mailing Address: | 24499 Sw Grahams Ferry Rd, WILSONVILLE |
State: | OR |
Postal Code: | 970707523 |
Phone Number: | 5035706732 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2007 |
NPI Last Update Date: | 07/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |