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NPI Code Detail

MEDICARE: GARY HANSEN PT

MEDICARE: GARY HANSEN PT
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
1225100000XPhysical TherapistPT3286WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1192455OTHERWALABOR & INDUSTRIES
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780784868
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY HANSEN PT
Provider Business Mailing Address
First Line : 8041 13TH AVE NW
Second Line :
City : SEATTLE
State : WA
Zip : 98117-4204
Country : US
Telephone Number : 206-782-5999
Fax Number :
Provider Business Practice Location Address
First Line : 5025 25TH AVE NE
Second Line : SUITE 201
City : SEATTLE
State : WA
Zip : 98105-4151
Country : US
Telephone Number : 206-524-6702
Fax Number : 206-524-6703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 01/24/2008

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Directions to “ GARY HANSEN PT” Practice Location

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