Provider Demographics
NPI:1215624069
Name:HANSEN, SARAH MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHELLE
Last Name:HANSEN
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 1:3112 196TH AVE SW # 224
Mailing Address - Street 2:
Mailing Address - City:LAKEBAY
Mailing Address - State:WA
Mailing Address - Zip Code:98349-8113
Mailing Address - Country:US
Mailing Address - Phone:360-535-2628
Mailing Address - Fax:
Practice Address - Street 1:3112 196TH AVE SW
Practice Address - Street 2:
Practice Address - City:LAKEBAY
Practice Address - State:WA
Practice Address - Zip Code:98349-8113
Practice Address - Country:US
Practice Address - Phone:360-535-2628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60766064163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn