Individual
DOUGLAS DUANE HUNTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1377 N 10TH AVE, STAYTON, OR 97383-2037
(503) 769-8470
(503) 769-9860
Mailing address
1377 N 10TH AVE, STAYTON, OR 97383-2037
(503) 769-8470
(503) 769-9860
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA00977
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500614409
—
OR
Enumeration date
01/24/2007
Last updated
04/15/2022
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