Provider Demographics
NPI:1366507030
Name:HUGGINS, STEPHEN M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:HUGGINS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1061
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:OR
Mailing Address - Zip Code:97055-1061
Mailing Address - Country:US
Mailing Address - Phone:503-939-3375
Mailing Address - Fax:503-427-1931
Practice Address - Street 1:38740 PROCTOR BLVD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-8030
Practice Address - Country:US
Practice Address - Phone:039-393-3755
Practice Address - Fax:503-427-1931
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0846103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical