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Individual

CORY R HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4476 W VAN GIESEN ST STE B, WEST RICHLAND, WA 99353-5411
(509) 967-1503
(509) 967-1768
Mailing address
4476 W VAN GIESEN ST STE B, WEST RICHLAND, WA 99353-5411
(509) 967-1503
(509) 967-1768

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD 3852
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2028645
WA
Enumeration date
08/30/2006
Last updated
01/18/2011
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