Provider Demographics
NPI:1467712950
Name:HOFFMAN, ALLISON C (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:C
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7810 SW ALAMEDA LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-5908
Mailing Address - Country:US
Mailing Address - Phone:503-332-2591
Mailing Address - Fax:
Practice Address - Street 1:1750 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-9540
Practice Address - Country:US
Practice Address - Phone:503-582-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ORMD169190207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500679021Medicaid
ORR177855Medicare PIN
ORR177852Medicare PIN
ORR177854Medicare PIN
OR500679021Medicaid
ORR177856Medicare PIN
ORR177853Medicare PIN