Healthcare Provider Details

I. General information

NPI: 1912194192
Provider Name (Legal Business Name): AMANDA LYNN HOFFMAN N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 NE COWLS ST
MCMINNVILLE OR
97128-4802
US

IV. Provider business mailing address

518 NE COWLS ST
MCMINNVILLE OR
97128-4802
US

V. Phone/Fax

Practice location:
  • Phone: 971-241-9647
  • Fax:
Mailing address:
  • Phone: 971-241-9647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1685
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number6211
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: