Provider Demographics
NPI:1568408912
Name:HANSCOM, DAVID ALFRED (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALFRED
Last Name:HANSCOM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3130 E MADISON ST
Mailing Address - Street 2:#205
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4264
Mailing Address - Country:US
Mailing Address - Phone:206-329-2393
Mailing Address - Fax:206-329-9614
Practice Address - Street 1:550 17TH AVE
Practice Address - Street 2:#500
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5788
Practice Address - Country:US
Practice Address - Phone:206-320-2800
Practice Address - Fax:206-320-2887
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00018423207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB37879Medicare PIN
A06738Medicare UPIN