Healthcare Provider Details

I. General information

NPI: 1831533108
Provider Name (Legal Business Name): BENJAMIN RICHARD HUEBNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 COLBY AVE
EVERETT WA
98201-1665
US

IV. Provider business mailing address

16318 E BERRY AVE
CENTENNIAL CO
80015-4050
US

V. Phone/Fax

Practice location:
  • Phone: 425-404-8227
  • Fax:
Mailing address:
  • Phone: 720-252-4618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License NumberMD61021283
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: