Provider Demographics
NPI:1336241314
Name:HANSON, JO TAMAYAO (MSW)
Entity Type:Individual
Prefix:MS
First Name:JO
Middle Name:TAMAYAO
Last Name:HANSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-0202
Mailing Address - Country:US
Mailing Address - Phone:206-478-3503
Mailing Address - Fax:425-482-1237
Practice Address - Street 1:12601 NE WOODINVILLE DR STE B1
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-8704
Practice Address - Country:US
Practice Address - Phone:206-478-3503
Practice Address - Fax:425-482-1237
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health