Individual
KENNETH DEAN HOFFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(971) 404-3366
Mailing address
PO BOX 4008, PORTLAND, OR 97208-4008
(503) 372-2740
(503) 372-2754
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006564
—
OR
Enumeration date
06/28/2006
Last updated
02/04/2008
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