Individual
GARY HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5025 25TH AVE NE, SUITE 201, SEATTLE, WA 98105-4151
(206) 524-6702
(206) 524-6703
Mailing address
8041 13TH AVE NW, SEATTLE, WA 98117-4204
(206) 782-5999
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3286
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
192455
LABOR & INDUSTRIES
WA
05
—
8400590
—
WA
Enumeration date
09/25/2006
Last updated
01/24/2008
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