Provider Demographics
NPI:1629591078
Name:VAN HATCH, ABE HOWARD (MA)
Entity type:Individual
Prefix:
First Name:ABE
Middle Name:HOWARD
Last Name:VAN HATCH
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9920 SW BUCKSKIN TER
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-7549
Mailing Address - Country:US
Mailing Address - Phone:925-577-5371
Mailing Address - Fax:
Practice Address - Street 1:9920 SW BUCKSKIN TER
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7549
Practice Address - Country:US
Practice Address - Phone:503-979-5371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61001122101YM0800X
ORC6103101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health