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NPI Code Detail

MEDICARE: DR. SHIRLEY MAY HANSON PMHNP, PHD

MEDICARE:  DR. SHIRLEY MAY HANSON  PMHNP, PHD
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
1103TC2200XClinical Child & Adolescent Psychologist084051100N6 PMHNP-PPOR

General Provider Information

NPI Number : 1578588539
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHIRLEY MAY HANSON PMHNP, PHD
Provider Business Mailing Address
First Line : 8325 SW CARMEL CT
Second Line :
City : PORTLAND
State : OR
Zip : 97223-6951
Country : US
Telephone Number : 503-245-8099
Fax Number : 503-452-8571
Provider Business Practice Location Address
First Line : 7912 SW 35TH AVE
Second Line : SUITE 6
City : PORTLAND
State : OR
Zip : 97219-2427
Country : US
Telephone Number : 503-452-8571
Fax Number : 503-452-8571
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/08/2007

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Directions to “ DR. SHIRLEY MAY HANSON PMHNP, PHD” Practice Location

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