Provider Demographics
NPI:1568346310
Name:HAFEMAN, AMANDA KAYE (RN)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:KAYE
Last Name:HAFEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52673 SHEENA PL
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-3329
Mailing Address - Country:US
Mailing Address - Phone:503-410-2642
Mailing Address - Fax:
Practice Address - Street 1:58401 LINDSAY LN
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OR
Practice Address - Zip Code:97053-9303
Practice Address - Country:US
Practice Address - Phone:503-410-2642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202106001RN163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health