Provider Demographics
NPI:1063558807
Name:HOBBS, JUNE ELLEN (CNM)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:ELLEN
Last Name:HOBBS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24850 SE STARK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-8316
Mailing Address - Country:US
Mailing Address - Phone:503-491-9444
Mailing Address - Fax:503-661-3430
Practice Address - Street 1:24850 SE STARK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-8316
Practice Address - Country:US
Practice Address - Phone:503-491-9444
Practice Address - Fax:503-661-3430
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200650131NP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR200650131NPOtherSTATE LICENSE