DR TRACEY HOFFMAN & ASSOCIATES PC (NPI# 1104099464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104099464 |
| Entity Type | Organization |
| Organization Name | DR TRACEY HOFFMAN & ASSOCIATES PC |
| Practice Address |
1210 Se Oak St Portland OR 97214 |
| Mailing Address |
2615 Ne 20th Ave Portland OR 97212 |
| Practice Telephone | 5033206272 |
| Practice Fax Number | 5032842873 |
| Mailing Telephone | 5033206272 |
| Mailing Fax Number | 5032842873 |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |
| Authorized Official Name | DR. TRACEY ELIZABETH HOFFMAN (PRESIDENT) |
| Authorized Official Telephone | 5033206272 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PY3352 | WA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
OR1724 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OREGON MEDICAL ASSISTANCE | 005909 | 01 |
| Street Address |
1210 SE OAK ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437131646 | Charles Way Harrison | Psychologist | 1210 Se Oak St, Portland, OR 97214-1427 | 2005-11-15 |
| 1093078677 | David Michael Martin | Counselor | 1210 Se Oak St, Suite 3, Portland, OR 97214-1427 | 2012-06-19 |
| 1215299565 | Lisa Marie Koralewicz | Social Worker | 1210 Se Oak St, Portland, OR 97214-1427 | 2012-06-12 |
| 1326322702 | Aziz Gazipura | Psychologist | 1210 Se Oak St, Suite 1, Portland, OR 97214-1427 | 2011-10-04 |
| 1982909438 | Jamie Young | Psychologist | 1210 Se Oak St, Portland, OR 97214 | 2011-01-13 |
| 1215258496 | Kerry Lee Powers | Counselor | 1210 Se Oak St, Suite 5, Portland, OR 97214-1427 | 2010-06-22 |
| 1194966523 | Serena Barton | Counselor | 1210 Se Oak St, Portland, OR 97214-1427 | 2009-03-15 |
| 1558513846 | Diane Havnen-smith | Social Worker | 1210 Se Oak St, Portland, OR 97214-1427 | 2008-10-17 |
| 1619123148 | Tracey Hoffman | Psychologist | 1210 Se Oak St, Portland, OR 97214-1427 | 2008-08-15 |
| 1568627875 | Christina Lynn Zimmerman | Counselor | 1210 Se Oak St, Portland, OR 97214-1427 | 2008-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1336772243 | Alexandra Mcbryde | Acupuncturist | 959 Se Division St, #315, Portland, OR 97214 | 2020-02-19 |
| 1356973770 | Laura Kille | Counselor | Wise Counsel and Comfort, 2045 Se Hawthorne Blvd., Portland, OR 97214 | 2020-02-05 |
| 1639616436 | Erin Elizabeth Weaver | Acupuncturist | 1330 Se Cesar E Chavez Blvd. Center for Natural Meidici, Portland, OR 97214 | 2017-01-31 |
| 1780126045 | Katherine Aravamudan, Lpc, LLC | Community/Behavioral Health | 1312 E. Burnside Street, Portland, OR 97214 | 2016-11-17 |
| 1003358441 | Michelle Jean Meadows | Massage Therapist | 2804 Se Lincoln St, Portland, OR 97214 | 2016-11-16 |
| 1629429311 | Stephanie Tolentino | Counselor | 605 Se Cesar E Chavez Blvd., Portland, OR 97214 | 2016-06-24 |
| 1790141166 | Marian Iris Dixon | Massage Therapist | 3810 Se Belmont St., Earthbody Wellness Center East, Portland, OR 97214 | 2016-01-14 |
| 1194194589 | Lutheran Community Services Northwest | Community/Behavioral Health | 605 Se Cesar E Chavez Bld, Portland, OR 97214 | 2015-09-16 |
| 1497123566 | Michele R. Stokes | Specialist | 2311 East Burnside B1, Portland, OR 97214 | 2015-09-08 |
| Find all providers in zip 97214 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007387 | Lyle Vintinner | Psychologist | 53 Baxter Blvd Ste 3, Portland, ME 04101-1827 | 2020-09-11 |
| 1194341297 | Natalie Dawn Mitchell | Psychologist | 3762 Sw Council Crest Dr, Portland, OR 97239-1595 | 2020-06-24 |
| 1992331607 | Erin A. Mueller | Psychologist | 718 Sw Alder St Ste 200, Portland, OR 97205-3423 | 2020-03-14 |
| 1952940520 | Timothy Allen Cooper | Psychologist | 3331 Sw Hamilton Ct, Portland, OR 97239-1256 | 2019-12-31 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1093373631 | Emily Catherine Stasko | Psychologist | 1950 Nw Raleigh St Apt 201, Portland, OR 97209-1775 | 2019-05-29 |
| 1174094544 | Juniper Psychological Services | Psychologist | 2827 Ne Alberta St, Portland, OR 97211-6350 | 2018-12-11 |
| 1528539335 | Mark G Kiefner Phd LLC | Psychologist | 225 Commercial St Ste 403, Portland, ME 04101-6603 | 2018-12-06 |
| 1467941831 | Shannon Madore | Psychologist | 3710 Sw Us Veterans Hospital Rd # R&d66, Portland, OR 97239-2964 | 2018-05-01 |
| 1033637202 | Kaylin Jones | Psychologist | 1235 Se Division Street, Suite 115, Portland, OR 97202-9720 | 2017-09-07 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.