Provider Demographics
NPI:1386985489
Name:RICHARD HSU, DM., PC
Entity type:Organization
Organization Name:RICHARD HSU, DM., PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-614-1177
Mailing Address - Street 1:1789 NW 173RD AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-4817
Mailing Address - Country:US
Mailing Address - Phone:503-614-1177
Mailing Address - Fax:503-629-5608
Practice Address - Street 1:1789 NW 173RD AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4817
Practice Address - Country:US
Practice Address - Phone:503-614-1177
Practice Address - Fax:503-629-5608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD76671223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty