Organization
L. KEITH HANSON PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELODIE WHITE (ADMINISTRATOR)
(509) 689-2525
Entity
Organization
Contact information
Practice address
520 W. INDIAN AVENUE, BREWSTER, WA 98812
(590) 689-2525
(509) 689-3247
Mailing address
PO BOX 337, BREWSTER, WA 98812-0337
(509) 689-2525
(509) 689-3247
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
503894
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7126980
—
WA
Enumeration date
08/09/2007
Last updated
01/11/2013
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