Provider Demographics
NPI:1780923565
Name:PHANGIA, HANSEN H (BC-HIS)
Entity type:Individual
Prefix:
First Name:HANSEN
Middle Name:H
Last Name:PHANGIA
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 SE SUNNYSIDE RD
Mailing Address - Street 2:SUITE 300-N
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5738
Mailing Address - Country:US
Mailing Address - Phone:503-659-5115
Mailing Address - Fax:503-659-5968
Practice Address - Street 1:230 N 1680 E
Practice Address - Street 2:SUITE R3
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2579
Practice Address - Country:US
Practice Address - Phone:435-673-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7096237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist