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General NPI Number Information
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NPI Number | 1457890527
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Entity Type | Individual
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Provider Name | JOSH HUDSON LPN
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Gender | Male
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 1601 E 4TH PLAIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98661-3713
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Country | US
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Telephone | 360-696-4061
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Fax |
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Provider Business Mailing Address
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Address Line | 8603 SE 133RD PL
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City | HAPPY VALLEY
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State | OR
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Zip | 97086-6395
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number | 201393950LPN
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License Number State | OR
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