Individual
JENNIFER R HANSEN IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 E PIONEER AVE, PUYALLUP, WA 98372-3265
(253) 697-8548
(253) 697-8590
Mailing address
325 E PIONEER AVE, PUYALLUP, WA 98372-3265
(253) 697-8548
(253) 697-8590
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
RC00041345
WA
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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