Healthcare Provider Details

I. General information

NPI: 1902231772
Provider Name (Legal Business Name): ERIC R HANSON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 WAINWRIGHT DR WALLA WALLA VA HEALTHCARE SYSTEM(116)
WALLA WALLA WA
99362
US

IV. Provider business mailing address

77 WAINWRIGHT DR WALLA WALLA VA MEDICAL CENTER (116)
WALLA WALLA WA
99362-3975
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5551
  • Fax:
Mailing address:
  • Phone: 509-525-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY26679
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPSYC.PY.60865003
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: