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General NPI Number Information
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NPI Number | 1417251430
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Entity Type | Individual
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Provider Name | DANIELLE NICOLE HANSEN LICENSE
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Gender | Female
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 3731 S ORCHARD ST APT. 3
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City | TACOMA
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State | WA
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Zip | 98466-7708
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Country | US
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Telephone | 253-324-4281
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Fax |
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Provider Business Mailing Address
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Address Line | 3731 S ORCHARD ST APT. 3
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City | TACOMA
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State | WA
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Zip | 98466-7708
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Country | US
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Telephone | 253-324-4281
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | MA 60084763
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License Number State | WA
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