Provider Demographics
NPI:1760456818
Name:HANSEN, TERRENCE MARTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:MARTIN
Last Name:HANSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3962-D CENTER ST N.E.
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301
Mailing Address - Country:US
Mailing Address - Phone:503-362-8892
Mailing Address - Fax:503-362-9593
Practice Address - Street 1:3962-D CENTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301
Practice Address - Country:US
Practice Address - Phone:503-362-8892
Practice Address - Fax:503-362-9593
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor