Provider Demographics
NPI:1235014655
Name:DR HERNANDEZWOLFE
Entity type:Organization
Organization Name:DR HERNANDEZWOLFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PILAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ-WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:443-220-3755
Mailing Address - Street 1:1942 NW KEARNEY ST STE 31
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1465
Mailing Address - Country:US
Mailing Address - Phone:443-220-3755
Mailing Address - Fax:
Practice Address - Street 1:1942 NW KEARNEY ST STE 31
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1465
Practice Address - Country:US
Practice Address - Phone:443-220-3755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty