Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2729 | WA |
N | 111NR0400X | Rehabilitation Chiropractor | 2729 | WA |
NPI | 1124235650 |
---|---|
Provider Name | Dr. Patricia Hansen |
First Address | Friday Harbor, WA 98250-3300 |
Second Address | Friday Harbor, WA 98250-9606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
210471100001 | CHIROPRATIC (01) | WA |