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1154713188
STACY MARIE RUDY
PORTLAND, OR
NPI
1154713188
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Former Name
STACY MARIE ABRAHAM
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA179627)
Enumeration Date
2015-02-27
Last Update Date
2020-11-18
Business Address
Mrs. STACY MARIE RUDY PA-C
6640 SW REDWOOD LN
PORTLAND, OR 97224-7187
Phone number: 503-620-7358
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Mailing Address
Mrs. STACY MARIE RUDY PA-C
800 SW 13TH AVE
PORTLAND, OR 97205-1902
Phone number: 503-221-0161
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