Provider Demographics
NPI:1578945473
Name:ANDERSON, HOPE
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12655 SW HARLEQUIN DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-6239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:866-311-3712
Practice Address - Street 1:12655 SW HARLEQUIN DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-6239
Practice Address - Country:US
Practice Address - Phone:971-777-3319
Practice Address - Fax:866-311-3712
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202106713NP-PP363LP0808X
OR20124178RN163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator