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 STE 210
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-3295
Mailing Address - Country:US
Mailing Address - Phone:360-254-6161
Mailing Address - Fax:360-803-0847
Practice Address - Street 1:200 NE MOTHER JOSEPH PL STE 110
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3293
Practice Address - Country:US
Practice Address - Phone:360-254-6161
Practice Address - Fax:360-803-0847
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-11-21
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Provider Licenses
StateLicense IDTaxonomies
MT116772363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant