Provider Demographics
NPI:1861652059
Name:HANNAHS, GARY ALAN (DC)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:ALAN
Last Name:HANNAHS
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 1:8221 NE HAZEL DELL AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8153
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8221 NE HAZEL DELL AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8153
Practice Address - Country:US
Practice Address - Phone:360-573-0729
Practice Address - Fax:360-573-0797
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60021341111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor