Healthcare Provider Details

I. General information

NPI: 1336117241
Provider Name (Legal Business Name): BEATRICE GENEVIEVE HANZELI PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 19TH AVE E
SEATTLE WA
98112-4006
US

IV. Provider business mailing address

501 19TH AVE E
SEATTLE WA
98112-4006
US

V. Phone/Fax

Practice location:
  • Phone: 206-860-3746
  • Fax: 206-860-0343
Mailing address:
  • Phone: 206-860-3746
  • Fax: 206-860-0343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2419
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: