Provider Demographics
NPI:1982626057
Name:HOHNSTEIN, ROGER (LMT)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:
Last Name:HOHNSTEIN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 NE BROADWAY ST STE 125
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1500
Mailing Address - Country:US
Mailing Address - Phone:503-477-8222
Mailing Address - Fax:971-373-8648
Practice Address - Street 1:2100 NE BROADWAY ST
Practice Address - Street 2:STE 125
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1569
Practice Address - Country:US
Practice Address - Phone:503-477-8222
Practice Address - Fax:971-373-8648
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3904174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist