MEDICARE: DOUGLAS P HANSEN OD

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	152W00000X	Optometrist	OD00002055	WA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	410043367	OTHER	WA	RAIL ROAD MEDICARE
4	410045030	OTHER	WA	RAIL ROAD MEDICARE
5	410021676	OTHER	WA	RAIL ROAD MEDICARE
6	410045029	OTHER	OR	RAIL ROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1871600122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS P HANSEN OD

Provider Business Mailing Address
First Line	:	9419 CAPSTAN DR NE
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-4624
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9419 CAPSTAN DR NE
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-4624
Country	:	US
Telephone Number	:	206-780-5087
Fax Number	:

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	06/03/2026

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Directions to “ DOUGLAS P HANSEN OD” Practice Location

Language	Start Address	Practice Location

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