Provider Demographics
NPI:1700931151
Name:HOCHTRITT, ROBIN L (RN, LCSW, QMHP, MSW)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:L
Last Name:HOCHTRITT
Suffix:
Gender:F
Credentials:RN, LCSW, QMHP, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16790 SW 108TH AVE
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-4516
Mailing Address - Country:US
Mailing Address - Phone:503-639-1376
Mailing Address - Fax:
Practice Address - Street 1:2415 SE 43RD AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-1600
Practice Address - Country:US
Practice Address - Phone:503-238-0705
Practice Address - Fax:503-236-7166
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL31481041C0700X
101YM0800X
OR163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health