Provider Demographics
NPI:1235402280
Name:HUDDLESTON, HELEN LOUISE (RPH)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:LOUISE
Last Name:HUDDLESTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34419 NE WOLCOTT ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-2202
Mailing Address - Country:US
Mailing Address - Phone:541-967-6730
Mailing Address - Fax:541-967-6741
Practice Address - Street 1:2500 SANTIAM HWY SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-5265
Practice Address - Country:US
Practice Address - Phone:541-967-6730
Practice Address - Fax:547-967-6741
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist