Provider Demographics
NPI:1750936373
Name:M. HUNDLEY SUBER, LLC
Entity type:Organization
Organization Name:M. HUNDLEY SUBER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARION
Authorized Official - Middle Name:HUNDLEY
Authorized Official - Last Name:SUBER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:971-232-3412
Mailing Address - Street 1:4039 N MISSISSIPPI AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1477
Mailing Address - Country:US
Mailing Address - Phone:971-232-3412
Mailing Address - Fax:971-203-7302
Practice Address - Street 1:4039 N MISSISSIPPI AVE STE 309
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1477
Practice Address - Country:US
Practice Address - Phone:971-232-3412
Practice Address - Fax:971-203-7302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2024-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty