Individual
NATHAN HANTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3303 SW BOND AVE STE 8, PORTLAND, OR 97239
(503) 494-7772
(503) 418-3283
Mailing address
3303 SW BOND AVE STE 8, PORTLAND, OR 97239-4501
(503) 494-7772
(503) 418-3283
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
28285
CA
103G00000X
Clinical Neuropsychologist
Primary
2970
OR
Other
Enumeration date
06/22/2016
Last updated
12/27/2018
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