Healthcare Provider Details

I. General information

NPI: 1568092302
Provider Name (Legal Business Name): NOOR HAMDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date: 07/07/2026
Reactivation Date: 07/28/2026

III. Provider practice location address

1 SERENITY LN
COBURG OR
97408-9350
US

IV. Provider business mailing address

PO BOX 8549
COBURG OR
97408-1313
US

V. Phone/Fax

Practice location:
  • Phone: 541-692-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: