Individual
HEATHER LYNNE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3000
Mailing address
19 MONTREAL ST APT 2, PORTLAND, ME 04101-2715
(858) 395-9119
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1834
ME
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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