Healthcare Provider Details

I. General information

NPI: 1659870996
Provider Name (Legal Business Name): DONNA ESTELLE HOFFMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 02/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 HAROLD DR NE
SALEM OR
97305-1339
US

IV. Provider business mailing address

PO BOX 17818
SALEM OR
97305-7818
US

V. Phone/Fax

Practice location:
  • Phone: 503-363-2021
  • Fax:
Mailing address:
  • Phone: 503-363-2021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number200842383RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: