Provider Demographics
NPI:1174363691
Name:PAUDEL, KUSUM (MD)
Entity type:Individual
Prefix:MS
First Name:KUSUM
Middle Name:
Last Name:PAUDEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 NE 139TH S
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686
Mailing Address - Country:US
Mailing Address - Phone:360-397-1985
Mailing Address - Fax:
Practice Address - Street 1:2211 NE 139TH S
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686
Practice Address - Country:US
Practice Address - Phone:360-397-1985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2025-08-14
Deactivation Date:2024-12-12
Deactivation Code:
Reactivation Date:2025-08-14
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program