Provider Demographics
NPI:1144285727
Name:HOEKSEMA, CATHARINA A (MD)
Entity type:Individual
Prefix:
First Name:CATHARINA
Middle Name:A
Last Name:HOEKSEMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHARINA
Other - Middle Name:A
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5625 NE ELAM YOUNG PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6422
Mailing Address - Country:US
Mailing Address - Phone:503-352-3791
Mailing Address - Fax:503-352-3793
Practice Address - Street 1:5625 NE ELAM YOUNG PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6422
Practice Address - Country:US
Practice Address - Phone:503-352-3791
Practice Address - Fax:503-352-3793
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22348208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
22348OtherMD LICENSE
H13867Medicare UPIN
ORR131405Medicare PIN