Provider Demographics
NPI:1316915812
Name:HANSON, LAURA JAYNE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JAYNE
Last Name:HANSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1914 10TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-2822
Mailing Address - Country:US
Mailing Address - Phone:206-235-1898
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE # 359885
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-6412
Practice Address - Fax:206-744-5997
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH0022169183500000X
WAPH000221691835P1200X, 1835P2201X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care