Individual
EDWARD HOAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
1190 BROADWAY ST NE, SALEM, OR 97301-1141
(503) 393-4273
Mailing address
3056 RAINBOW LOOP, HUBBARD, OR 97032-9697
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000110359
OR
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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