Provider Demographics
NPI:1932503455
Name:HOGAN, HANNAH (LAC)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 NE JONES RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3915
Mailing Address - Country:US
Mailing Address - Phone:510-684-0057
Mailing Address - Fax:
Practice Address - Street 1:929 SW SIMPSON AVE
Practice Address - Street 2:#150
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3599
Practice Address - Country:US
Practice Address - Phone:510-684-0057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC167881171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist