Individual
DR. JENNIFER MALIA HOGANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
444 NW ELKS DR, CORVALLIS, OR 97330-3745
(541) 754-1288
(541) 754-2772
Mailing address
3680 NW SAMARITAN DR, CORVALLIS, OR 97330-3737
(541) 754-1288
(541) 754-2772
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1686
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005767
—
OR
Enumeration date
10/09/2006
Last updated
08/12/2008
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