Healthcare Provider Details

I. General information

NPI: 1962408815
Provider Name (Legal Business Name): NONA L. HANSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NONA L. CHAPA MD

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 04/20/2025
Certification Date: 04/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6133 NE 188TH PL
KENMORE WA
98028-3211
US

IV. Provider business mailing address

1400 E KINCAID ST ATTN: CREDENTIALING
MOUNT VERNON WA
98274-4127
US

V. Phone/Fax

Practice location:
  • Phone: 213-855-3465
  • Fax:
Mailing address:
  • Phone: 360-428-2500
  • Fax: 360-428-6485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA73987
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberT8115
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA73987
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60376809
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: