Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH00003153 | WA |
NPI | 1194973677 |
---|---|
Provider Name | Merry Lauren Hanson |
First Address | Redmond, WA 98052-3387 |
Second Address | Redmond, WA 98052-3387 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2008 |
Last Update Date | 08/09/2008 |