1952346280 NPI number — ELLEN NONA HOYVEN P.T.

Table of content: ELLEN NONA HOYVEN P.T. (NPI 1952346280)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952346280 NPI number — ELLEN NONA HOYVEN P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOYVEN
Provider First Name:
ELLEN NONA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952346280
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8100 SW NYBERG ST STE 130
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUALATIN
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97062-8375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-885-8677
Provider Business Mailing Address Fax Number:
503-885-0676

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8100 SW NYBERG ST
Provider Second Line Business Practice Location Address:
SUITE 130
Provider Business Practice Location Address City Name:
TUALATIN
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97062-8438
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-620-2400
Provider Business Practice Location Address Fax Number:
503-620-2410
Provider Enumeration Date:
06/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1647 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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