Provider Demographics
NPI:1134305790
Name:HUDSON, SHAWN M (LMP)
Entity Type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:M
Last Name:HUDSON
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E SHARP AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1835
Mailing Address - Country:US
Mailing Address - Phone:509-328-9610
Mailing Address - Fax:509-328-5268
Practice Address - Street 1:301 E SHARP AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1835
Practice Address - Country:US
Practice Address - Phone:509-328-9610
Practice Address - Fax:509-328-5268
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00024311175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath