Healthcare Provider Details

I. General information

NPI: 1619121670
Provider Name (Legal Business Name): JANE HOBART PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 SE MORRISON ST STE 400
PORTLAND OR
97214-2344
US

IV. Provider business mailing address

516 SE MORRISON ST STE 400
PORTLAND OR
97214-2344
US

V. Phone/Fax

Practice location:
  • Phone: 503-222-0707
  • Fax:
Mailing address:
  • Phone: 503-222-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: