Provider Demographics
NPI:1245685684
Name:HANSEN, LISA (RN, ONCC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:RN, ONCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9428 NW SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97231-2679
Mailing Address - Country:US
Mailing Address - Phone:503-880-8910
Mailing Address - Fax:
Practice Address - Street 1:1498 SE TECH CENTER PL
Practice Address - Street 2:SUITE 240
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9591
Practice Address - Country:US
Practice Address - Phone:360-597-1309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200170076CNS364SX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology