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General NPI Number Information
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NPI Number | 1023251279
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Entity Type | Individual
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Provider Name | KATHLEEN EDGE HANSON RN, LMP
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Gender | Female
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 03/06/2014
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Provider Practice Location Address
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Address Line | 7206 - 267TH ST NW
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City | STANWOOD
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State | WA
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Zip | 98292
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Country | US
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Telephone | 360-629-3303
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Fax | 360-629-1044
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Provider Business Mailing Address
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Address Line | PO BOX 234
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City | STANWOOD
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State | WA
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Zip | 98292
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Country | US
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Telephone | 360-629-3303
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Fax | 360-387-5656
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA00003323
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License Number State | WA
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