Provider Demographics
NPI:1922404219
Name:HOKE, JENNIE (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:
Last Name:HOKE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4823 MEADOWS RD
Mailing Address - Street 2:SUITE 127
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-2529
Mailing Address - Country:US
Mailing Address - Phone:503-216-1580
Mailing Address - Fax:971-282-0069
Practice Address - Street 1:4823 MEADOWS RD
Practice Address - Street 2:SUITE 127
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2529
Practice Address - Country:US
Practice Address - Phone:503-216-1580
Practice Address - Fax:971-282-0069
Is Sole Proprietor?:No
Enumeration Date:2014-11-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA174336363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical