Provider Demographics
NPI:1245472810
Name:HANSEN, ANNE T (LMP)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:T
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6356 38TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3026
Mailing Address - Country:US
Mailing Address - Phone:206-937-6595
Mailing Address - Fax:
Practice Address - Street 1:9250 45TH AVE SW
Practice Address - Street 2:FAUNTLEROY MASSAGE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-2633
Practice Address - Country:US
Practice Address - Phone:206-937-4140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-29
Last Update Date:2009-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012263225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist