Healthcare Provider Details

I. General information

NPI: 1992828644
Provider Name (Legal Business Name): LESLIE EILEEN HOJEM M.S. CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 SW US VETERANS HOSPITAL RD
PORTLAND OR
97239-2964
US

IV. Provider business mailing address

12214 NW 11TH AVE
VANCOUVER WA
98685-2462
US

V. Phone/Fax

Practice location:
  • Phone: 503-273-5342
  • Fax:
Mailing address:
  • Phone: 360-574-5024
  • Fax: 360-574-5024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number21803
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: