Individual
ANTHONY CHRISTOPHER HUACUJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 3RD ST, TILLAMOOK, OR 97141-3430
(503) 815-2295
Mailing address
33118 DOUGLAS LN, WARRENTON, OR 97146-7274
(909) 230-8035
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
201501052RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201501052RN
NURSING LICENSE
OR
Enumeration date
12/21/2021
Last updated
12/21/2021
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