Provider Demographics
NPI:1174677256
Name:HSU, RICHARD P (DMD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:P
Last Name:HSU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Practice Address - Country:US
Practice Address - Phone:503-614-1177
Practice Address - Fax:503-629-5608
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD76671223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry