Provider Demographics
NPI:1528100310
Name:HOFFMAN, LESLIE (OTR)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:ROTHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:PO BOX 1377
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97440-1377
Mailing Address - Country:US
Mailing Address - Phone:541-696-3473
Mailing Address - Fax:541-636-3480
Practice Address - Street 1:598 E 13TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4267
Practice Address - Country:US
Practice Address - Phone:541-636-3473
Practice Address - Fax:541-636-3480
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR989736225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00394299OtherRAIL ROAD MEDICARE
ORR121559Medicare PIN