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NPI Code Detail

MEDICARE: MS. JANET GAIL HANSOM MD

MEDICARE: MS. JANET GAIL HANSOM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD00029047WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568465870
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JANET GAIL HANSOM MD
Provider Business Mailing Address
First Line : 2116 EAST SECTION STREET
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98274-9124
Country : US
Telephone Number : 360-428-1700
Fax Number : 360-848-4350
Provider Business Practice Location Address
First Line : 2116 EAST SECTION STREET
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98274-9124
Country : US
Telephone Number : 360-428-1700
Fax Number : 360-848-4350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 02/25/2011

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