Provider Demographics
NPI:1649484544
Name:HETTINGER, BARBARA D (MD, PHD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:D
Last Name:HETTINGER
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1130 NW 22ND AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2900
Mailing Address - Country:US
Mailing Address - Phone:503-274-4884
Mailing Address - Fax:503-274-4897
Practice Address - Street 1:9135 SW BARNES RD
Practice Address - Street 2:SUITE 985
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6601
Practice Address - Country:US
Practice Address - Phone:503-297-3336
Practice Address - Fax:503-297-3338
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD27950207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine