Nathan Hantke, Ph.D.
Clinical Neuropsychologist in Portland, OR. Individual provider (NPI-1).
NPI number1265883151
StatusActive
Last updated in NPPESDec 27, 2018
Details
- NPI
- 1265883151
- Entity type
- Individual (NPI-1)
- Name
- Nathan Hantke
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 22, 2016
- Last updated
- Dec 27, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 2970 | OR | Yes |
| 103G00000X | Clinical Neuropsychologist | 28285 | CA |
Practice location
3303 Sw Bond Ave Ste 8Portland, OR 97239
Phone 503-494-7772 · Fax 503-418-3283
Mailing address
3303 Sw Bond Ave Ste 8Portland, OR 97239-4501
Phone 503-494-7772 · Fax 503-418-3283
Other practice locations
3710 Sw Us Veterans Hospital Rd
Portland, OR 97239-2964
Portland, OR 97239-2964
Phone 503-220-8262
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