Healthcare Provider Details

I. General information

NPI: 1124315569
Provider Name (Legal Business Name): MINGMING ZHANG HOHENSEE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2011
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2951 HUNTER WAY
WEST LINN OR
97068-2241
US

IV. Provider business mailing address

2951 HUNTER WAY
WEST LINN OR
97068-2241
US

V. Phone/Fax

Practice location:
  • Phone: 503-744-0613
  • Fax:
Mailing address:
  • Phone: 503-744-0613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1069970
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: