Individual
MONIQUKA HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2040 SE POWELL BLVD, PORTLAND, OR 97202-2345
(503) 226-4060
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 294-1681
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
24-CRM-3023
OR
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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