Provider Demographics
NPI:1164543872
Name:HANSEN, KAREN EMILY (MSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:EMILY
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 N 35TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8870
Mailing Address - Country:US
Mailing Address - Phone:206-789-3878
Mailing Address - Fax:
Practice Address - Street 1:753 N 35TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8870
Practice Address - Country:US
Practice Address - Phone:206-789-3878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000045661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA94-3050611Medicare UPIN