Provider Demographics
NPI:1558427625
Name:HANNAH, PETER (MA)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:HANNAH
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 WESTLAKE AVE N
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2704
Mailing Address - Country:US
Mailing Address - Phone:206-799-6566
Mailing Address - Fax:
Practice Address - Street 1:1800 WESTLAKE AVE N
Practice Address - Street 2:SUITE 305
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2704
Practice Address - Country:US
Practice Address - Phone:206-799-6566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010774101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health