Provider Demographics
NPI:1265812648
Name:HUNDLEY, DUSTIN MATTHEW (MS, DC)
Entity type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:MATTHEW
Last Name:HUNDLEY
Suffix:
Gender:M
Credentials:MS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 E MILL PLAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-2010
Mailing Address - Country:US
Mailing Address - Phone:360-718-2346
Mailing Address - Fax:360-718-2347
Practice Address - Street 1:1905 MOUNTAIN VIEW LN STE 400
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-2264
Practice Address - Country:US
Practice Address - Phone:503-357-2187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-01
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5649111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor