Provider Demographics
NPI:1225202294
Name:HANSON CHIROPRACTIC CLINIC INC.
Entity Type:Organization
Organization Name:HANSON CHIROPRACTIC CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-306-2494
Mailing Address - Street 1:11300 ROOSEVELT WAY NE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6242
Mailing Address - Country:US
Mailing Address - Phone:206-306-2494
Mailing Address - Fax:206-306-9351
Practice Address - Street 1:3002 NE 127TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:206-306-2494
Practice Address - Fax:206-306-9351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-21
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB20102Medicare PIN