Healthcare Provider Details

I. General information

NPI: 1801903646
Provider Name (Legal Business Name): HILLSBORO ADVANCED SURGICAL CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 NE ELAM YOUNG PKWY STE 200
HILLSBORO OR
97124-6422
US

IV. Provider business mailing address

5625 NE ELAM YOUNG PKWY STE 200
HILLSBORO OR
97124-6422
US

V. Phone/Fax

Practice location:
  • Phone: 503-352-3791
  • Fax: 503-352-3793
Mailing address:
  • Phone: 503-352-3791
  • Fax: 503-352-3793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD22348
License Number StateOR

VIII. Authorized Official

Name: CATHARINA A HOEKSEMA
Title or Position: PRESIDENT
Credential: MD
Phone: 503-352-3791