Individual
ELISABETH C HOOTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-2392
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
AP133541
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
201911036NP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
373156401
—
TX
Enumeration date
03/26/2017
Last updated
07/21/2022
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