Provider Demographics
NPI:1568825321
Name:HANSEN, STEVEN DOUGLAS (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DOUGLAS
Last Name:HANSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W 5TH AVE STE 323
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2800
Mailing Address - Country:US
Mailing Address - Phone:509-724-4300
Mailing Address - Fax:509-755-6569
Practice Address - Street 1:801 W 5TH AVE STE 323
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2800
Practice Address - Country:US
Practice Address - Phone:509-724-4300
Practice Address - Fax:509-755-6569
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61026944208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation