Healthcare Provider Details

I. General information

NPI: 1669285557
Provider Name (Legal Business Name): JOCELYNN LAUREN HANSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E OLIVE ST
SEATTLE WA
98122-2735
US

IV. Provider business mailing address

6400 SOUTHCENTER BLVD
TUKWILA WA
98188-2547
US

V. Phone/Fax

Practice location:
  • Phone: 206-901-2010
  • Fax: 206-901-2010
Mailing address:
  • Phone: 206-901-2000
  • Fax: 206-901-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC.70114107
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMG.70114150
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: