Healthcare Provider Details

I. General information

NPI: 1457721698
Provider Name (Legal Business Name): HCC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 02/26/2021
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 NW EASTMAN PKWY STE 265
GRESHAM OR
97030-3860
US

IV. Provider business mailing address

1550 NW EASTMAN PKWY STE 265
GRESHAM OR
97030-3860
US

V. Phone/Fax

Practice location:
  • Phone: 503-669-1966
  • Fax: 503-667-6599
Mailing address:
  • Phone: 503-669-1966
  • Fax: 503-667-6599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5106
License Number StateOR

VIII. Authorized Official

Name: DR. AMY LYNN HANSON
Title or Position: OWNER
Credential: DC
Phone: 503-669-1966