Individual
SHANNON GABRIELLE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3622 ENSIGN RD NE, OLYMPIA, WA 98506-5081
(360) 742-5000
(360) 742-5019
Mailing address
PO BOX 34703, MS: 820-5-PCO, SEATTLE, WA 98124-1703
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD60293423
WA
207Q00000X
Family Medicine Physician
51866
MN
207Q00000X
Family Medicine Physician
MD60293423
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-37427
MEDICA
—
05
—
2020161
—
WA
01
—
P00767187
MEDICARE RAILROAD
—
Enumeration date
05/08/2008
Last updated
04/22/2026
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