Provider Demographics
NPI:1275526816
Name:HAMBLIN, RICHARD S (PA-C)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:HAMBLIN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2318 PORTLAND RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1372
Mailing Address - Country:US
Mailing Address - Phone:503-538-0411
Mailing Address - Fax:503-538-6141
Practice Address - Street 1:2318 PORTLAND RD
Practice Address - Street 2:SUITE 300
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1372
Practice Address - Country:US
Practice Address - Phone:503-538-0411
Practice Address - Fax:503-538-6141
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2011-08-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant