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General NPI Number Information
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NPI Number | 1437563186
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Entity Type | Individual
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Provider Name | JERZY HUBERT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 1110 SE ALDER ST STE 301
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City | PORTLAND
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State | OR
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Zip | 97214-2400
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Country | US
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Telephone | 971-436-1012
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Fax | 971-231-0249
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Provider Business Mailing Address
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Address Line | 1110 SE ALDER ST STE 301 PMB 67
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City | PORTLAND
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State | OR
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Zip | 97214-2400
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Country | US
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Telephone | 971-436-1012
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Fax | 971-231-0249
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 222421
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License Number State | OR
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