Healthcare Provider Details

I. General information

NPI: 1134245566
Provider Name (Legal Business Name): CHRISTOPHER JAMES HOBART M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 NW BROADWAY
PORTLAND OR
97209-3580
US

IV. Provider business mailing address

232 NW 6TH AVE
PORTLAND OR
97209-3609
US

V. Phone/Fax

Practice location:
  • Phone: 503-228-7134
  • Fax: 503-501-5679
Mailing address:
  • Phone: 503-294-1681
  • Fax: 503-294-4321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberMD177130
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: