Provider Demographics
NPI:1912194192
Name:HOFFMAN, AMANDA LYNN (ND)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 NE COWLS ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-4802
Mailing Address - Country:US
Mailing Address - Phone:971-241-9647
Mailing Address - Fax:
Practice Address - Street 1:518 NE COWLS ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4802
Practice Address - Country:US
Practice Address - Phone:971-241-9647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1685175F00000X
OR6211172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No172M00000XOther Service ProvidersMechanotherapist