Healthcare Provider Details

I. General information

NPI: 1801909031
Provider Name (Legal Business Name): PEGGY ANN HANSEN MN, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8490 MUKILTEO SPEEDWAY
MUKILTEO WA
98275-3206
US

IV. Provider business mailing address

8490 MUKILTEO SPEEDWAY
MUKILTEO WA
98275-3206
US

V. Phone/Fax

Practice location:
  • Phone: 425-356-6516
  • Fax: 425-356-6515
Mailing address:
  • Phone: 425-356-6516
  • Fax: 425-356-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAP30001528
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN00076386
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: