Provider Demographics
NPI:1124493739
Name:HANSON, JANET
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 MEDCALF
Mailing Address - Street 2:GENESIS REHAB SERVICES
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563
Mailing Address - Country:US
Mailing Address - Phone:360-249-2273
Mailing Address - Fax:
Practice Address - Street 1:800 MEDCALF STREET
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563
Practice Address - Country:US
Practice Address - Phone:360-249-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOC60494849224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant