GREGORY DAVID RUDOLF (NPI# 1518079664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518079664 |
| Entity Type | Organization |
| Organization Name | GREGORY DAVID RUDOLF |
| Other Organization Name | GREGORY DAVID RUDOLF, MD PS |
| Practice Address |
1101 Madison St Ste 200 Seattle WA 98104-1306 |
| Mailing Address |
Po Box 94546 Seattle WA 98124-6846 |
| Practice Telephone | 2063862013 |
| Mailing Telephone | 2063204476 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-03-24 |
| Authorized Official Name | DR. GREGORY DAVID RUDOLF (PHYSICIAN) |
| Authorized Official Telephone | 2063862013 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
MD00041809 | WA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Gregory David Rudolf, MD PS | Doing Business As Name - Organization |
| Street Address |
1101 MADISON ST STE 200 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98104-1306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154324812 | Gregory A. Grant | Podiatrist | 1101 Madison St, Suite 301, Seattle, WA 98104-1306 | 2005-05-24 |
| 1699309260 | Kristin D Covey | Registered Nurse | 1101 Madison St, Ste 700, Seattle, WA 98104-3599 | 2020-02-23 |
| 1083151914 | Alaska Plastic Surgery LLC | Plastic Surgery | 1101 Madison St, Suite 1270, Seattle, WA 98104-1306 | 2017-01-30 |
| 1740727106 | Proliance Surgeons, Inc., P.s. | Obstetrics & Gynecology | 1101 Madison St, Suite 950, Seattle, WA 98104-1306 | 2017-01-24 |
| 1326584673 | Proliance Surgeons, Inc., P.s. | Obstetrics & Gynecology | 1101 Madison St, Suite 1150, Seattle, WA 98104-1306 | 2017-01-10 |
| 1790231116 | Alexandra Brook Fleming | Social Worker | 1101 Madison St, Suite 500, Seattle, WA 98104-1306 | 2016-08-26 |
| 1558815142 | Chelsea Reed | Nurse Practitioner | 1101 Madison St, Suite 1050, Seattle, WA 98104-1306 | 2016-08-11 |
| 1730633637 | Jake Weissman Dds Msd Pllc | Dentist | 1101 Madison St, Suite 1290, Seattle, WA 98104-1306 | 2016-08-09 |
| 1053764423 | Susan M Vetto | Nurse Practitioner | 1101 Madison St, Suite 850, Seattle, WA 98104-1306 | 2016-07-20 |
| 1790145530 | Laura Bartlett | Nurse Practitioner | 1101 Madison St, Ste 700, Seattle, WA 98104-1306 | 2016-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394312 | Richard Charles Harruff | Pathology | King County Medical Examiners Office, 325 Ninth Avenue, Seattle, WA 98104 | 2020-04-13 |
| 1558999474 | Nathan Richard Benner | Student in an Organized Health Care Education/Training Program | Uw Medicine-harborview Medical Center Orthopaedics, 325 Ninth Avenue, Seattle, WA 98104 | 2020-03-27 |
| 1063058493 | Brook, LLC. | Health Educator | 311 1/2 Occidental Ave South, Suite 210, Seattle, WA 98104 | 2019-11-20 |
| 1609418813 | Stephanie Amanda Ann Mason | Student in an Organized Health Care Education/Training Program | 325 9th Avenue, Mail Stop #359796, Seattle, WA 98104 | 2019-10-09 |
| 1013480250 | Robert Kenneth Lozier | Pedorthist | Norm Maleng Building, 410 9th Ave, 4th Floor, Seattle, WA 98104 | 2019-01-10 |
| 1548739576 | Lee Hanses | Physical Therapist | 1124 Columbia Street, Level P1, Suite P100, Seattle, WA 98104 | 2018-11-20 |
| 1821579095 | Karissa Lin Lee | Pharmacist | 401 Broadway #2075, Seattle, WA 98104 | 2018-08-27 |
| 1477042091 | Maham Jehangir | Student in an Organized Health Care Education/Training Program | 325 9th Ave Department of Radiology, Seattle, WA 98104 | 2018-05-09 |
| 1740786581 | Philip Daniel Tolley | Student in an Organized Health Care Education/Training Program | 325 9th Ave. Mail Stop#359796, 7th Floor Center Tower Rm #73.1, Seattle, WA 98104 | 2018-04-02 |
| 1528564242 | Vanessa Dawn Leonhard | Student in an Organized Health Care Education/Training Program | 325 9th Ave, 7th Floor Center Tower Room 73.1, Mail Stop #359796, Seattle, WA 98104 | 2018-04-02 |
| Find all providers in zip 98104 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
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| 1194342162 | Bicycle Health Medical Group Pa | Family Medicine | 1700 Westlake Ave N Ste 200, Seattle, WA 98109-6212 | 2020-06-25 |
| 1407973779 | Jesus B. Sy | Family Medicine | 2535 Beacon Ave S, Suite A, Seattle, WA 98144-5125 | 2007-03-23 |
| 1700053790 | Thomas J Deal Md | Family Medicine | 5343 Tallman Ave Nw, 203, Seattle, WA 98107-3931 | 2008-05-09 |
| 1851302764 | Thomas John Deal | Family Medicine | 5343 Tallman Ave Nw, Suite 203, Seattle, WA 98107-3931 | 2006-08-10 |
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| 1134748643 | Workit Health Mi Pllc | Family Medicine | 4505 Pacific Hwy E Ste C2, Fife, WA 98424-2638 | 2020-04-14 |
| 1508322363 | Heal From Addiction, LLC | Family Medicine | 7 S Howard St Ste 210, Spokane, WA 99201-3816 | 2019-02-18 |
| 1366953630 | Ideal Option, Pllc | Family Medicine | 8921 E Alki Ave Ste 1, Spokane Valley, WA 99212-2705 | 2017-10-13 |
| 1962928200 | E & H Holdings, LLC | Family Medicine | 708 E Penn St, Moses Lake, WA 98837 | 2017-08-18 |
| 1851816409 | Ideal Option, Pllc | Family Medicine | 406 Se 131st Ave Ste 104, Vancouver, WA 98683-4031 | 2017-08-04 |
| 1467903054 | Ideal Option, Pllc | Family Medicine | 1725 Continental Pl, Ste C, Mount Vernon, WA 98273-5693 | 2016-10-18 |
| 1912395211 | Consistent Care Services Spc, Ps | Family Medicine | 1612 4th St, Suite 200, Marysville, WA 98270-5045 | 2015-01-08 |
| 1558685925 | Central Washington Sleep Diagnostic Center, Pllc | Family Medicine | 2323 W Broadway Ave Ste 4, Moses Lake, WA 98837 | 2010-03-15 |
| 1497081855 | Jsn Inc | Family Medicine | 1135 Ellis St, Bellingham, WA 98225-5246 | 2009-10-20 |
| 1710110820 | Elina Chernyak | Family Medicine | 302 5th St Ste 3, Clarkston, WA 99403-1801 | 2009-08-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.