Individual
CAROL JEANNE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
72A CENTENNIAL LOOP STE 150, EUGENE, OR 97401-2447
(971) 219-7949
Mailing address
2092 PRASLIN ST, EUGENE, OR 97402-1025
(541) 968-5958
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000002476
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4854649
ODOL
OR
Enumeration date
03/05/2019
Last updated
03/05/2019
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