Provider Demographics
NPI:1770239576
Name:HOFFMAN, AMANDA MEAGAN (NP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MEAGAN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:MEAGAN
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1437 SW HALL ST APT A
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97201-2630
Mailing Address - Country:US
Mailing Address - Phone:541-915-8410
Mailing Address - Fax:
Practice Address - Street 1:1000 SE TECH CENTER DR STE 102
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5547
Practice Address - Country:US
Practice Address - Phone:360-487-4660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202201963NP-PP363L00000X
WAAP61271083363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner