Healthcare Provider Details

I. General information

NPI: 1437183928
Provider Name (Legal Business Name): JEFFREY T. HANSPETERSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10030 SW 210TH ST
VASHON WA
98070-6584
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-1703
US

V. Phone/Fax

Practice location:
  • Phone: 206-463-3671
  • Fax: 206-463-3613
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD00043102
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: