Provider Demographics
NPI:1619029956
Name:HUBBS, ERIC CHRISTOPHER (DC, CCST)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:CHRISTOPHER
Last Name:HUBBS
Suffix:
Gender:M
Credentials:DC, CCST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 SW AUGUSTA DR
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97006-1365
Mailing Address - Country:US
Mailing Address - Phone:503-848-0432
Mailing Address - Fax:
Practice Address - Street 1:17937 SW TUALATIN VALLEY HWY
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97006-4441
Practice Address - Country:US
Practice Address - Phone:503-591-5022
Practice Address - Fax:503-591-5023
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT69329Medicare UPIN