Healthcare Provider Details

I. General information

NPI: 1225252216
Provider Name (Legal Business Name): PETER J. HANSON, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11314 4TH AVE W STE 103
EVERETT WA
98204-6926
US

IV. Provider business mailing address

11314 4TH AVE W STE 103
EVERETT WA
98204-6926
US

V. Phone/Fax

Practice location:
  • Phone: 425-355-3739
  • Fax: 425-514-8353
Mailing address:
  • Phone: 425-355-3739
  • Fax: 425-514-8353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberWA2723
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00015073
License Number StateWA

VIII. Authorized Official

Name: DR. PETER J HANSON
Title or Position: OWNER
Credential: DC
Phone: 425-355-3739