Provider Demographics
NPI:1629176672
Name:HOHNER, TERRANCE DANIEL (OD)
Entity Type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:DANIEL
Last Name:HOHNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2832 NW THURMAN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2207
Mailing Address - Country:US
Mailing Address - Phone:503-245-6484
Mailing Address - Fax:
Practice Address - Street 1:7850 SW BARBUR BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-3089
Practice Address - Country:US
Practice Address - Phone:503-245-6484
Practice Address - Fax:503-245-7872
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1233ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU26049Medicare UPIN
OR121565Medicare PIN