Individual
AMANDA S HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10000 SE MAIN ST STE 365, PORTLAND, OR 97216-2474
(503) 261-4430
(503) 261-4436
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01446
WV
363A00000X
Physician Assistant
Primary
PA158658
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500646896
—
OR
Enumeration date
11/18/2009
Last updated
05/25/2023
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