Individual
MR. RICHARD ENNISS HANSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA, MPAS
Contact information
Practice address
33710 9TH AVE S STE 7, FEDERAL WAY, WA 98003-6734
(253) 517-7058
(833) 471-6226
Mailing address
33710 9TH AVE S STE 7, FEDERAL WAY, WA 98003-6734
(253) 517-7058
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200266340A
—
OK
Enumeration date
10/13/2005
Last updated
01/16/2025
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