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Individual

MR. LUCAS CHARLES HANERHOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT, ATC

Contact information

Practice address
1905 SE 192ND AVE STE 109, CAMAS, WA 98607-7415
(360) 210-5440
(360) 210-7731
Mailing address
1905 SE 192ND AVE STE 109, CAMAS, WA 98607-7415
(360) 210-5440
(360) 210-7731

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT.PT.70119694-CP
WA
225100000X
Physical Therapist
PTL.0020876
CO
2255A2300X
Athletic Trainer
24-01534
KS

Other

Enumeration date
02/21/2019
Last updated
05/07/2026
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