Provider Demographics
NPI:1801989413
Name:HANSON, DENISE A (ARNP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:HANSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:A
Other - Last Name:HEILGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:909 N BROADWAY
Mailing Address - Street 2:PBO
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-1409
Mailing Address - Country:US
Mailing Address - Phone:425-317-0699
Mailing Address - Fax:425-317-0291
Practice Address - Street 1:900 PACIFIC AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4168
Practice Address - Country:US
Practice Address - Phone:425-304-6040
Practice Address - Fax:425-304-6045
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006972363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9644485Medicaid
WAQ41928Medicare UPIN
WAG8878212Medicare PIN
WA8852805Medicare ID - Type Unspecified