Individual
KRISTINA R HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
611 31ST AVE SW, PUYALLUP, WA 98373-3723
(253) 848-5951
Mailing address
3908 10TH ST SE, PUYALLUP, WA 98374-2188
(253) 848-5951
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP60782628
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000000000
—
WA
Enumeration date
08/08/2017
Last updated
08/08/2017
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