Hursey, Phyllis Deshun
Hursey, Phyllis Deshun is an sole proprietor health care provider with primary practice located at 1206 Se 11Th Ave , Portland OR 97214-3601. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Hursey, Phyllis Deshun can be contacted via phone (503) 389-1166.Contact Information
Primary practice address
1206 Se 11Th Ave
Portland OR 97214-3601
Phone: (503) 389-1166
Fax: (503) 389-1161
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD26240 | Oregon |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | MD26240 | Oregon |
Profile Details
| NPI number | 1427029537 |
|---|---|
| LBN Legal business name | Hursey, Phyllis Deshun |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 27th, 2006 |
| Last updated | Dec 8th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427029537 | NPPES |
| Oregon | Other | MD26240 | LICENCE |
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