Provider Demographics
NPI:1194986539
Name:JAMES D HANSON M D PS INC
Entity type:Organization
Organization Name:JAMES D HANSON M D PS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-362-8000
Mailing Address - Street 1:3207 NE 125TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-4516
Mailing Address - Country:US
Mailing Address - Phone:206-362-8000
Mailing Address - Fax:206-362-8002
Practice Address - Street 1:3207 NE 125TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-4516
Practice Address - Country:US
Practice Address - Phone:206-362-8000
Practice Address - Fax:206-362-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00012843261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1349208Medicaid
WAA04656Medicare UPIN
WAG000102088Medicare PIN