Provider Demographics
NPI:1275673949
Name:HUBBARD, BRETT J (ND)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:J
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11140 SW LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-7631
Mailing Address - Country:US
Mailing Address - Phone:503-238-5982
Mailing Address - Fax:
Practice Address - Street 1:14000 SE JOHNSON RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-2316
Practice Address - Country:US
Practice Address - Phone:503-786-7272
Practice Address - Fax:503-786-7799
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1006175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath