Provider Demographics
NPI:1851479992
Name:HANSEN, ERIC DAVIN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DAVIN
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 1:12951 NE BEL RED RD STE 120
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2628
Mailing Address - Country:US
Mailing Address - Phone:425-869-5808
Mailing Address - Fax:425-455-2910
Practice Address - Street 1:12951 NE BEL RED RD STE 120
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2628
Practice Address - Country:US
Practice Address - Phone:425-869-5808
Practice Address - Fax:425-455-2910
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U44181Medicare UPIN
WAAB34734Medicare ID - Type Unspecified