Michael Hollenback, P.A.-C.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA00498 Issued in OR

Practice address

9800 SE Sunnyside Rd
Clackamas, OR 97015-9750

Phone

(503) 653-6440

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003923293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11603 SE FLAVEL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972665980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159750",
            "telephone_number": "503-653-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLENBACK",
        "first_name": "MICHAEL",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OR",
            "license": "PA00498",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10003619",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dieter Franz Hoffmann Jr., M.D.
• Kurt Heinz Hoffmann, PT
• Joshua Hawkin Hollabaugh, MD
• Amanda Holland-Yang, MD
• Belinda Chang Holland, M.D.
• Louis Holmes
• Taylor Anne Hong-Hall, MA, CCC-SLP
• Gene George Hong, M.D.
• Susan Seely Hook, MS, LMFT
• Hope RTH LLC

• Surgical Physician Assistant in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Surgical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.