Provider Demographics
NPI:1740441245
Name:HANSEN, DARCI JANELL (MD)
Entity type:Individual
Prefix:
First Name:DARCI
Middle Name:JANELL
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MD
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 3777
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3777
Mailing Address - Country:US
Mailing Address - Phone:503-413-4278
Mailing Address - Fax:
Practice Address - Street 1:700 NE MULTNOMAH ST
Practice Address - Street 2:SUITE 1600
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2131
Practice Address - Country:US
Practice Address - Phone:503-249-5454
Practice Address - Fax:503-249-5498
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD157730207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500647955Medicaid
ORR175189OtherMEDICARE PTAN