Individual
MS. DIANE MICHELLE HUDDLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
528 COTTAGE ST NE STE 204A, SALEM, OR 97301-3828
(503) 559-2654
Mailing address
1475 MCCOY AVE NE, SALEM, OR 97303-6465
(503) 364-3997
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12344
OR
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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