Individual provider Active NPI

Jeffrey Duane Hudson, PAC. ATC

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1154432995
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
116772 Issued in MT
Practice address
200 NE Mother Joseph PL Ste 110
Vancouver, WA 98664-3293
Phone
(360) 254-6161
Fax
(360) 803-0847
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 116772 MT Primary

Addresses

Primary practice location

200 NE Mother Joseph PL Ste 110
Vancouver, WA 98664-3293

Mailing address

200 NE Mother Joseph PL Ste 210
Vancouver, WA 98664-3295
Phone (360) 254-6161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111018000745 WA Practitioner - Physician Assistant 6901095454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Surgical Specialists PCGroup PAC ID 4183527153, 118 clinicians

Practice addresses (Care Compare)

200 NE Mother Joseph PL
110 Rebound Orthopedics
Vancouver, WA 98664-3293
Phone (360) 254-6161

200 NE Mother Joseph PL
Suite 210
Vancouver, WA 98664-3295

2211 NE 139TH St
Legacy Salmon Creek Medical Center
Vancouver, WA 98686-2742
Phone (360) 487-1000

400 NE Mother Joseph PL
Peacehealth Southwest Medical Center
Vancouver, WA 98664-3200
Phone (360) 514-2000

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
116772MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Frances Mahon Deaconess Hospital Past Accepting new patients
J and D Physical Therapy Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jhudson21850@reboundmd.gardenplot.direct-ci.com
  • Direct secure messaging: jeff.hudsonpac.p1@direct.reboundmd.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1154432995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643295",
            "telephone_number": "360-254-6161",
            "fax_number": "360-803-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 110",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643293",
            "telephone_number": "360-254-6161",
            "fax_number": "360-803-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "JEFFREY",
        "middle_name": "DUANE",
        "name_prefix": "Mr.",
        "credential": "PAC. ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "116772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.