Healthcare Provider Details

I. General information

NPI: 1164622718
Provider Name (Legal Business Name): AMANDA KATHLEEN HURLIMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9555 SW BARNES RD SUITE 255
PORTLAND OR
97225
US

IV. Provider business mailing address

808 SW 15TH AVE
PORTLAND OR
97205-1907
US

V. Phone/Fax

Practice location:
  • Phone: 503-274-4994
  • Fax: 503-243-5849
Mailing address:
  • Phone: 503-274-4994
  • Fax: 503-243-5849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD163192
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: