Active NPI
Kendra Gudz, LMP
- Specialist
- Snoqualmie, WA
National Provider Identifier
1902932775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 17224
- Practice address
- 38579 SE River St #13
Snoqualmie, WA 98065 - Phone
- (425) 443-2515
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 17224 | WA | Primary |
Addresses
Primary practice location
38579 SE River St #13
Snoqualmie, WA 98065
Mailing address
PO Box 2043
North Bend, WA 98045-2043
Phone (425) 443-2515
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17224 | Other | WA | STATE LIC. NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17224 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475107200000",
"number": "1902932775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2043",
"city": "NORTH BEND",
"state": "WA",
"postal_code": "980452043",
"telephone_number": "425-443-2515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38579 SE RIVER ST #13",
"city": "SNOQUALMIE",
"state": "WA",
"postal_code": "98065",
"telephone_number": "425-443-2515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUDZ",
"first_name": "KENDRA",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2016-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "17224",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LIC. NUMBER",
"identifier": "17224",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Snoqualmie, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.