1952650178 NPI number — DR. PAULETTE LOUISE HUGULET DC

Table of content: DR. PAULETTE LOUISE HUGULET DC (NPI 1952650178)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952650178 NPI number — DR. PAULETTE LOUISE HUGULET DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGULET
Provider First Name:
PAULETTE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUGULET
Provider Other First Name:
PAULETTE
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1952650178
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2502 COVE AVE
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
LA GRANDE
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-963-9355
Provider Business Mailing Address Fax Number:
541-663-1638

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2502 COVE AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
LA GRANDE
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-963-9355
Provider Business Practice Location Address Fax Number:
541-663-1638
Provider Enumeration Date:
09/04/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  5069 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 500667960 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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