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NPI Code Detail

MEDICARE: JEFFREY J HANSEN MD PC

MEDICARE: JEFFREY J HANSEN MD PC
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1770446429
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEFFREY J HANSEN MD PC
Provider Business Mailing Address
First Line : 2215 BROADWAY ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98663-3226
Country : US
Telephone Number : 360-906-7156
Fax Number : 360-696-3658
Provider Business Practice Location Address
First Line : 2215 BROADWAY ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98663-3226
Country : US
Telephone Number : 360-906-7156
Fax Number : 360-696-3658
Authorized Official
Title or Position : OWNER
Name : DR. JEFFREY JON HANSEN
Credential : MD
Telephone Number : 503-504-5700
Provider Enumeration Date : 12/08/2025
Last Update Date : 12/08/2025

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