Healthcare Provider Details

I. General information

NPI: 1730849241
Provider Name (Legal Business Name): HANSEN CHIROPRACTIC, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2021
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 NE MIDWAY BLVD STE A
OAK HARBOR WA
98277-2663
US

IV. Provider business mailing address

2000 N STATE ST
BELLINGHAM WA
98225-4218
US

V. Phone/Fax

Practice location:
  • Phone: 360-671-1710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: EDWARD LEWIS HANSEN
Title or Position: PRESIDENT
Credential:
Phone: 360-671-1710