Provider Demographics
NPI:1952650178
Name:HUGULET, PAULETTE LOUISE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:LOUISE
Last Name:HUGULET
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:PAULETTE
Other - Middle Name:LOUISE
Other - Last Name:HUGULET
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2502 COVE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850
Mailing Address - Country:US
Mailing Address - Phone:541-963-9355
Mailing Address - Fax:541-663-1638
Practice Address - Street 1:2502 COVE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850
Practice Address - Country:US
Practice Address - Phone:541-963-9355
Practice Address - Fax:541-663-1638
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5069111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500667960Medicaid