1073139713 NPI number — ANDREW J HUGHES MD

Table of content: ADDIE MARIE NIVENS LPN (NPI 1164687513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073139713 NPI number — ANDREW J HUGHES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANDREW J HUGHES MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073139713
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/18/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1634 NW EVERETT ST APT 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97209-2172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-471-1543
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
325 NW 21ST AVE STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97209-1179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-647-4297
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/18/2020

Additional Information

Authorized Official

Authorized Official Last Name:
HUGHES
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
PSYCHIATRIST
Authorized Official Telephone Number:
503-647-4297

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1396107876 . This is a "PERSONAL NPI" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




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