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Individual

THOMAS HAROLD HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
24216 WITTE RD SE, MAPLE VALLEY, WA 98038-6827
(425) 413-3583
Mailing address
14022 SE 158TH ST, RENTON, WA 98058-7812
(425) 277-1394

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT00006617
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8344194
WA
Enumeration date
05/17/2007
Last updated
01/04/2013
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