Provider Demographics
NPI:1801117494
Name:HANN, GENEVIEVE WERNER (MD)
Entity type:Individual
Prefix:DR
First Name:GENEVIEVE
Middle Name:WERNER
Last Name:HANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GENEVIEVE
Other - Middle Name:MARIE
Other - Last Name:WERNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 MADISON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1401 MADISON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1316
Practice Address - Country:US
Practice Address - Phone:206-386-6054
Practice Address - Fax:206-215-6027
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60298440207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2020710Medicaid