MEDICARE: HOPE A ZAK FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	200550139NP	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00450846	OTHER	OR	RR MEDICARE

General Provider Information

NPI Number	:	1659310415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOPE A ZAK FNP

Provider Business Mailing Address
First Line	:	PO BOX 4949
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-4949
Country	:	US
Telephone Number	:	503-215-6494
Fax Number	:	503-215-6644

Provider Business Practice Location Address
First Line	:	5279 N LOMBARD ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-4257
Country	:	US
Telephone Number	:	503-215-3300
Fax Number	:	503-215-3350

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	07/26/2024

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Directions to “ HOPE A ZAK FNP” Practice Location

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