Individual
EDWARD KRIST HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE, TACOMA, WA 98431-0001
(310) 738-1326
Mailing address
3021 E 2ND ST, LONG BEACH, CA 90803-5164
(310) 738-1326
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
564655
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
564655
RN
CA
Enumeration date
08/29/2018
Last updated
08/29/2018
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