Individual
ANDREA LEIGH HUXTABLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2701 NW VAUGHN ST STE 150, PORTLAND, OR 97210-5379
(503) 229-8455
(503) 229-7028
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA202788
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2177842
—
WA
05
—
500793275
—
OR
Enumeration date
03/26/2020
Last updated
01/05/2026
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