Individual
HANNAH FAE AULTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11782 SW BARNES RD STE 300, PORTLAND, OR 97225-5933
(503) 214-5200
(503) 906-6613
Mailing address
11782 SW BARNES RD STE 300, PORTLAND, OR 97225-5933
(503) 214-5200
(503) 906-6613
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD192931
OR
207XS0106X
Orthopaedic Hand Surgery Physician
MD192931
OR
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
MD192931
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500659811
—
OR
01
—
MD192931
OREGON LICENSE
OR
Enumeration date
04/03/2013
Last updated
08/29/2024
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