Provider Demographics
NPI:1003205972
Name:HUDSON, ELISHA MICHAEL (ND, DC)
Entity Type:Individual
Prefix:DR
First Name:ELISHA
Middle Name:MICHAEL
Last Name:HUDSON
Suffix:
Gender:M
Credentials:ND, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 N PARKWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-9156
Mailing Address - Country:US
Mailing Address - Phone:360-926-0026
Mailing Address - Fax:360-450-5044
Practice Address - Street 1:407 N PARKWAY AVE
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-9156
Practice Address - Country:US
Practice Address - Phone:360-926-0026
Practice Address - Fax:360-450-5044
Is Sole Proprietor?:No
Enumeration Date:2015-01-15
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60530908111N00000X
WANT60901841175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No111N00000XChiropractic ProvidersChiropractor