Provider Demographics
NPI:1972972024
Name:HANSEN, DANA (ARNP, CNM)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:HENSYEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4465 CORDATA PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8037
Mailing Address - Country:US
Mailing Address - Phone:360-738-2200
Mailing Address - Fax:360-752-5282
Practice Address - Street 1:1115 SE 164TH AVE
Practice Address - Street 2:DEPT 358
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9324
Practice Address - Country:US
Practice Address - Phone:360-738-2200
Practice Address - Fax:360-752-5282
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60604010176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife