Healthcare Provider Details

I. General information

NPI: 1508484015
Provider Name (Legal Business Name): ELISABETH MARIE HANSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2020
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NE TENNEY RD
VANCOUVER WA
98685-2831
US

IV. Provider business mailing address

3800 SE 22ND AVE
PORTLAND OR
97202-2918
US

V. Phone/Fax

Practice location:
  • Phone: 360-571-2573
  • Fax: 360-571-2567
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0017916
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH61054527
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: