Provider Demographics
NPI:1295391852
Name:HANSON, SANDRA M (FNP-C)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:M
Last Name:HANSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 SE OAK ST STE 202
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4287
Mailing Address - Country:US
Mailing Address - Phone:503-640-3724
Mailing Address - Fax:
Practice Address - Street 1:200 NE MOTHER JOSEPH PL STE 330
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3288
Practice Address - Country:US
Practice Address - Phone:360-514-2990
Practice Address - Fax:360-514-3508
Is Sole Proprietor?:No
Enumeration Date:2019-05-18
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60486763163W00000X
OR201403529RN163W00000X
OR202105802NP-PP363LF0000X
WAAP61193079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse