Provider Demographics
NPI:1699028555
Name:HOVLAND, VIRINIA (NP)
Entity Type:Individual
Prefix:MS
First Name:VIRINIA
Middle Name:
Last Name:HOVLAND
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:VIRINIA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-2964
Mailing Address - Country:US
Mailing Address - Phone:503-220-8262
Mailing Address - Fax:
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2020-05-08
Deactivation Date:2012-10-31
Deactivation Code:
Reactivation Date:2020-05-08
Provider Licenses
StateLicense IDTaxonomies
OR201808980NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner