Provider Demographics
NPI:1588651541
Name:HANSEN, RYAN N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:N
Last Name:HANSEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 NE 92ND ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-3661
Mailing Address - Country:US
Mailing Address - Phone:206-930-9985
Mailing Address - Fax:206-448-4406
Practice Address - Street 1:2324 EASTLAKE AVE E
Practice Address - Street 2:SUITE 405
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3345
Practice Address - Country:US
Practice Address - Phone:206-441-9174
Practice Address - Fax:206-448-4406
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00051750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH00051750OtherPHARMACIST LICENSE