Provider Demographics
NPI:1609205186
Name:HANSCHEN, CAROLINE (CNM, WHNP-BC, RNC-OB)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:HANSCHEN
Suffix:
Gender:F
Credentials:CNM, WHNP-BC, RNC-OB
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:GOURLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9040 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:JBLM
Mailing Address - State:WA
Mailing Address - Zip Code:98431
Mailing Address - Country:US
Mailing Address - Phone:253-968-1406
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE DEPT OBGYN
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-4210
Practice Address - Country:US
Practice Address - Phone:253-968-3751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA797616163WX0003X
WARN00150510163WX0003X
TN156445163WX0003X
CA23848363LW0102X
CA2077367A00000X
WAAP60417502367A00000X, 367A00000X
367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2139984Medicaid