Provider Demographics
NPI:1154432995
Name:HUDSON, JEFFREY DUANE (PAC ATC)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:DUANE
Last Name:HUDSON
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Gender:M
Credentials:PAC ATC
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Mailing Address - Street 1:200 NE MOTHER JOSEPH PL
Mailing Address - Street 2:SUITE 210
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-3299
Mailing Address - Country:US
Mailing Address - Phone:360-254-6161
Mailing Address - Fax:360-449-1139
Practice Address - Street 1:2900 12TH AVE N STE 140W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7507
Practice Address - Country:US
Practice Address - Phone:406-237-5050
Practice Address - Fax:406-272-3395
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-04-24
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Provider Licenses
StateLicense IDTaxonomies
MT116772363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant