Provider Demographics
NPI:1497276513
Name:HANSEN FOOT AND ANKLE LLC
Entity Type:Organization
Organization Name:HANSEN FOOT AND ANKLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-537-3777
Mailing Address - Street 1:16030 BOTHELL EVERETT HWY STE 160
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1794
Mailing Address - Country:US
Mailing Address - Phone:425-537-3777
Mailing Address - Fax:425-407-5502
Practice Address - Street 1:16030 BOTHELL EVERETT HWY STE 160
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1794
Practice Address - Country:US
Practice Address - Phone:425-537-3777
Practice Address - Fax:425-407-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO60714901213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty