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General NPI Number Information
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NPI Number | 1760260855
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Entity Type | Individual
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Provider Name | JAIRED HUDSON ARNP
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Gender | Male
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2200 NE NEFF RD STE 302
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City | BEND
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State | OR
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Zip | 97701-4279
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Country | US
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Telephone | 541-706-4220
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 NE NEFF RD
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City | BEND
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State | OR
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Zip | 97701-6015
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Country | US
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Telephone | 541-382-4321
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 105985
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 70686
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 201906971RN
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 95352640
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP61679484
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License Number State | WA
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Taxonomy #6
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 10044323
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License Number State | OR
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