Individual
DR. JIMMY DEE HUEBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7654 SW MOHAWK ST BLDG K, TUALATIN, OR 97062-8119
(503) 691-2000
(503) 961-2001
Mailing address
7654 SW MOHAWK ST BLDG K, TUALATIN, OR 97062-8119
(503) 691-2000
(503) 961-2001
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
MD23362
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100187860A
—
OK
05
—
1119809
—
OR
Enumeration date
07/24/2006
Last updated
09/13/2021
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