Provider Demographics
NPI:1902108442
Name:HOFFMANN, KURT HEINZ (PT)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:HEINZ
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7826 N FESSENDEN ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-1617
Mailing Address - Country:US
Mailing Address - Phone:828-593-9494
Mailing Address - Fax:
Practice Address - Street 1:2701 NW VAUGHN ST STE 140
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-5344
Practice Address - Country:US
Practice Address - Phone:503-871-3070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60152225100000X
NCP10859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist