Provider Demographics
NPI:1336457969
Name:HOEFLICH, HANNAH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:HOEFLICH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7415 N OATMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-1213
Mailing Address - Country:US
Mailing Address - Phone:503-928-2900
Mailing Address - Fax:503-289-0943
Practice Address - Street 1:7415 N OATMAN AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-1213
Practice Address - Country:US
Practice Address - Phone:503-928-2900
Practice Address - Fax:503-289-0943
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2643103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical