Individual
DR. BENNETH ANN HUSTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5100 SW MACADAM AVE, SUITE 200, PORTLAND, OR 97239-6102
(971) 202-5500
(971) 202-5555
Mailing address
5100 SW MACADAM AVE, SUITE 200, PORTLAND, OR 97239-6102
(971) 202-5500
(971) 202-5555
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
DO12837
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067593003
BLUE CROSS BLUE SHIELD #
OR
05
—
232132
—
OR
Enumeration date
05/26/2006
Last updated
01/22/2013
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