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Individual
HEIDEE I. HANSON
Active
Individual
HEIDEE I. HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60245253
WA
363A00000X
Physician Assistant
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336312495
—
WA
05
—
1925659
—
LA
Enumeration date
04/10/2008
Last updated
11/16/2011
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