Provider Demographics
NPI:1710086756
Name:HUHTALA, KRISTIN (MED)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:
Last Name:HUHTALA
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 CRESCENT AVE UNIT 226
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7405
Mailing Address - Country:US
Mailing Address - Phone:541-686-4310
Mailing Address - Fax:
Practice Address - Street 1:941 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-4611
Practice Address - Country:US
Practice Address - Phone:541-686-4310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist