Provider Demographics
NPI:1851928535
Name:MARNIE HANSEN, PLLC
Entity Type:Organization
Organization Name:MARNIE HANSEN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:206-954-1975
Mailing Address - Street 1:18122 W LAKE DESIRE DR SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9526
Mailing Address - Country:US
Mailing Address - Phone:206-954-1975
Mailing Address - Fax:
Practice Address - Street 1:18122 W LAKE DESIRE DR SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-9526
Practice Address - Country:US
Practice Address - Phone:206-954-1975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty