Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 201250066NP | OR |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 2012500066NP | OR |
NPI | 1083977417 |
---|---|
Provider Name | Katrina G Hoffman |
First Address | Corvallis, OR 97339-1188 |
Second Address | Albany, OR 97322-6182 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2012 |
Last Update Date | 04/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500650384 | (05) | OR |