Provider Demographics
NPI:1063796530
Name:HUFFMAN, JESSICA BROOKE (ND)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:BROOKE
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 NW 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-3907
Mailing Address - Country:US
Mailing Address - Phone:503-841-6828
Mailing Address - Fax:
Practice Address - Street 1:2 NW 3RD AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3907
Practice Address - Country:US
Practice Address - Phone:503-841-6828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath