Provider Demographics
NPI:1417356668
Name:PAYSENO, HANNAH (CPM, LDM)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:PAYSENO
Suffix:
Gender:F
Credentials:CPM, LDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1156 DEARBORN AVE NE
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-3806
Mailing Address - Country:US
Mailing Address - Phone:503-269-4114
Mailing Address - Fax:
Practice Address - Street 1:1156 DEARBORN AVE NE
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-3806
Practice Address - Country:US
Practice Address - Phone:503-269-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1015967-99374J00000X
OR10221134176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula