Healthcare Provider Details

I. General information

NPI: 1972657112
Provider Name (Legal Business Name): HONORA MADELINE HANLEY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 E MADISON ST STE 205
SEATTLE WA
98112-4214
US

IV. Provider business mailing address

2910 E MADISON ST STE 205
SEATTLE WA
98112-4214
US

V. Phone/Fax

Practice location:
  • Phone: 206-714-2946
  • Fax:
Mailing address:
  • Phone: 206-714-2946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number2309
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2309
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: