Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CH60530908 | WA |
Y | 175F00000X | Naturopath | NT60901841 | WA |
NPI | 1003205972 |
---|---|
Provider Name | Dr. Elisha Michael Hudson |
First Address | Battle Ground, WA 98604-9156 |
Second Address | Battle Ground, WA 98604-9156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2015 |
Last Update Date | 06/03/2019 |