Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | PG177811 | OR |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | PG177811 | OR |
NPI | 1205193463 |
---|---|
Provider Name | Emily Anne Huber |
First Address | Portland, OR 97239-3827 |
Second Address | Portland, OR 97239-3827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2012 |
Last Update Date | 07/12/2021 |