Healthcare Provider Details

I. General information

NPI: 1477113314
Provider Name (Legal Business Name): MONICA HANSON MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2019
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 221ST ST SW
BOTHELL WA
98021-8121
US

IV. Provider business mailing address

704 221ST ST SW
BOTHELL WA
98021-8121
US

V. Phone/Fax

Practice location:
  • Phone: 503-860-0645
  • Fax:
Mailing address:
  • Phone: 503-860-0645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number114755
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: