Healthcare Provider Details

I. General information

NPI: 1043306616
Provider Name (Legal Business Name): GARY HUDAK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 M AVE
ANACORTES WA
98221-3894
US

IV. Provider business mailing address

2601 M AVE
ANACORTES WA
98221-3894
US

V. Phone/Fax

Practice location:
  • Phone: 360-588-9017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD00035823
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD00035823
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: