Provider Demographics
NPI:1861223091
Name:RUDD VISION PLLC
Entity type:Organization
Organization Name:RUDD VISION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-791-8404
Mailing Address - Street 1:2910 S MERIDIAN STE 300
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-1283
Mailing Address - Country:US
Mailing Address - Phone:360-791-8404
Mailing Address - Fax:360-791-8404
Practice Address - Street 1:2910 S MERIDIAN STE 300
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-1283
Practice Address - Country:US
Practice Address - Phone:360-791-8404
Practice Address - Fax:360-791-8404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty