Provider Demographics
NPI:1124235650
Name:HANSEN, PATRICIA (DC)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3300
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-3300
Mailing Address - Country:US
Mailing Address - Phone:360-378-3537
Mailing Address - Fax:360-378-3582
Practice Address - Street 1:321 PRICE ST
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-9606
Practice Address - Country:US
Practice Address - Phone:360-378-3537
Practice Address - Fax:360-378-3582
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2729111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA210471100001OtherCHIROPRATIC