Provider Demographics
NPI:1962408815
Name:HANSON, NONA L (MD)
Entity type:Individual
Prefix:DR
First Name:NONA
Middle Name:L
Last Name:HANSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:NONA
Other - Middle Name:L
Other - Last Name:CHAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1400 E KINCAID ST
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-428-2500
Mailing Address - Fax:360-428-6485
Practice Address - Street 1:6133 NE 188TH PL
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-3211
Practice Address - Country:US
Practice Address - Phone:213-855-3465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73987174400000X, 207Q00000X
TXT8115207Q00000X
WAMD60376809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A739870Medicare ID - Type Unspecified
CAH79556Medicare UPIN