Provider Demographics
NPI:1255577458
Name:HERNANDEZ, ANNE LOUISE
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:LOUISE
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:LOUISE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:515 NW SALTZMAN RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-6098
Mailing Address - Country:US
Mailing Address - Phone:503-629-8181
Mailing Address - Fax:
Practice Address - Street 1:17225 NW MADRAS CT
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4671
Practice Address - Country:US
Practice Address - Phone:503-629-8181
Practice Address - Fax:503-629-8181
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter