Individual
IAN HANNACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NONE
Contact information
Practice address
1455 NW LEARY WAY STE 400A, SEATTLE, WA 98107-5138
(206) 504-3815
Mailing address
18726 S WESTERN AVE, GARDENA, CA 90248-3813
(310) 856-0800
(855) 568-2494
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
XXXXXXXX
WA
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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