Healthcare Provider Details

I. General information

NPI: 1346030749
Provider Name (Legal Business Name): JENNIFER HOBACK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 NE STUCKI AVE STE 230
HILLSBORO OR
97124-7328
US

IV. Provider business mailing address

3000 NE STUCKI AVE STE 230
HILLSBORO OR
97124-7328
US

V. Phone/Fax

Practice location:
  • Phone: 503-869-8108
  • Fax: 503-690-0678
Mailing address:
  • Phone: 503-869-8108
  • Fax: 503-690-0678

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: