Individual
MATTHEW HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1327 W SUPERIOR ST STE 101, SANDPOINT, ID 83864-2742
(503) 371-4044
Mailing address
1327 W SUPERIOR ST STE 101, SANDPOINT, ID 83864-2742
(503) 814-1700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/24/2018
Last updated
10/27/2022
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