Provider Demographics
NPI:1750694063
Name:HOFFMAN, MATTHEW (OT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9414 NE FOURTH PLAIN RD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6109
Mailing Address - Country:US
Mailing Address - Phone:360-892-5142
Mailing Address - Fax:360-892-2157
Practice Address - Street 1:9414 NE FOURTH PLAIN RD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6109
Practice Address - Country:US
Practice Address - Phone:360-892-5142
Practice Address - Fax:360-892-2157
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60119595225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics