Individual
LANCE J HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3620 SE POWELL BLVD STE 202, PORTLAND, OR 97202-1880
(503) 892-1189
Mailing address
3620 SE POWELL BLVD STE 202, PORTLAND, OR 97202-1880
(503) 892-1189
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
15-2370
OR
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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