MEDICARE: MS. ELLEN M HANISCH NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	A-108210	IA
2	363L00000X	Nurse Practitioner	110748	NE
3	363L00000X	Nurse Practitioner	AP60134362	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33314	OTHER	IA	WELLMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346248754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELLEN M HANISCH NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1624 SOUTH I STREET
Second Line	:	SUITE 305
City	:	TACOMA
State	:	WA
Zip	:	98405-5093
Country	:	US
Telephone Number	:	253-428-8700
Fax Number	:	253-383-3376

Provider Business Practice Location Address
First Line	:	11511 CANTERWOOD BLVD
Second Line	:	SUITE 45
City	:	GIG HARBOR
State	:	WA
Zip	:	98332-5813
Country	:	US
Telephone Number	:	253-858-4725
Fax Number	:	253-858-4452

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2005
Last Update Date	:	08/01/2012

Similar Medicare Providers

1477780922 — JUSTIN H. PIASECKI, M.D., PLLC
Practice Location Address:

11511 CANTERWOOD BLVD NW , SUITE 310
GIG HARBOR, WA
98332-5813

Practice Phone: 253-509-4438
Practice Fax:

1134354533 — HARBOR PLASTIC SURGERY CENTER PLLC
Practice Location Address:

11511 CANTERWOOD BLVD NW , SUITE 310
GIG HARBOR, WA
98332-5813

Practice Phone: 253-858-5040
Practice Fax: 888-843-2412

1306988860 — RAED N FAHMY
Practice Location Address:

11511 CANTERWOOD BLVD STE 100
GIG HARBOR, WA
98332-5813

Practice Phone: 253-382-3716
Practice Fax: 253-858-4978

1952306037 — LANCE LEBRECHT BEAR M.D.
Practice Location Address:

11511 CANTERWOOD BLVD NW , STE 205
GIG HARBOR, WA
98332-5813

Practice Phone: 253-530-2663
Practice Fax: 253-530-2675

1609865831 — MRS. DANA MICHELLE KNUTZEN M.S.
Practice Location Address:

11511 CANTERWOOD BLVD NW , STE 45
GIG HARBOR, WA
98332-5813

Practice Phone: 253-426-4772
Practice Fax: 253-426-6449

1669443032 — KENNETH S BERGMAN MD
Practice Location Address:

11511 CANTERWOOD BLVD NW , SUITE 50
GIG HARBOR, WA
98332-5813

Practice Phone: 253-851-5155
Practice Fax: 253-851-5367

Directions to “ MS. ELLEN M HANISCH NURSE PRACTITIONER” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.